Orthopedic Coding Alert

Question: Our surgeon did a microfracture chondroplasty in the medial compartment and performed a chondroplasty in the lateral compartment. Can we charge for both since they were done in separate compartments?

Florida Subscriber

Answer: You should not report both even though it's performed in two separate compartments. The work value of chrondroplasty performed in the lateral compartment is already included in the work value of microfracture chondroplasty performed in the medial compartment. Therefore, you should only report microfracture chondroplasty code 29879 (Arthroscopy, knee, surgical; abrasion arthroplasty [includes chondroplasty where necessary] or multiple drilling or microfracture).

However, if you'll look current CCI edits version 18.1, Medicare has assigned CPT® 29877 (chondroplasty) as a column 2 code for CPT® 29879 (Surgical arthroscopy of knee with microfracture chondroplasty) with a modifier indicator of "0" means you never unbundle these code pairs under any circumstances.