Orthopedic Coding Alert

Question: How does one code for a medial meniscectomy, synovectomy of medial, lateral, and patellofemoral compartments, and a chondroplasty of the patellofemoral and medial femoral condyle in a non-medicare patient?

Kansas Subscriber

Answer: You will report code 29881(Arthroscopy, knee, surgical; with meniscectomy [medial OR lateral, including any meniscal shaving] including debridement/shaving of articular cartilage [chondroplasty], same or separate compartment[s], when performed) for medial meniscectomy. For the extensive synovectomy, you will report code 29876 (Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments [e.g., medial or lateral]). You will not report the chondroplasty as 29877 (Arthroscopy, knee, surgical; debridement/shaving of articular cartilage [chondroplasty]) gets bundled in both the codes.

The correct answer to the question Bill Separate Incision for Syndesmosis Repair in Orthopedic Coding Alert, Vol. 15, No. 6, page 47 should be as follows:

You should report code 27814 (Open treatment of bimalleolar ankle fracture [e.g., lateral and medial malleoli, or lateral and posterior malleoli, or medial and posterior malleoli], includes internal fixation, when performed) as the procedure is more like a revision open reduction and internal fixation (ORIF) of a bimalleolar fracture. You report code 27829 (Open treatment of distal tibiofibular joint [syndesmosis] disruption, includes internal fixation, when performed) separately for the syndesmosis repair if a separate incision is made.