Orthopedic Coding Alert

Question: In a patient diagnosed with multiple loose bodies in the knee, lateral meniscus tear, and grade 3 chondromalacia, our surgeon did the following procedures:

1. Arthroscopic partial lateral meniscectomy.
2. Arthroscopic chondroplasty of the patella and trochlea.
3. Arthroscopic lateral release.
4. Open medial removal of a bony fragment in the patella with repair of the patient’s medial patellofemoral ligament on its medial aspect off the patella.

How can we report these procedures?

Florida Subscriber

Answer: For the arthroscopic partial meniscectomy, you 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). The code applies to medial as well as lateral meniscectomy. Note that this code is inclusive of chondroplasty. To avoid any bundling issues, you do not separately report the arthroscopic chondroplasty of the patella and trochlea. Consider code 29873 (Arthroscopy, knee, surgical; with lateral release) for arthroscopic lateral release. The bony fragment of the patella here implies the loose body that your surgeon is removing using the open approach. Confirm if your surgeon is also repairing the patient’s medial patellofemoral ligament. If so, you report code 27427 (Ligamentous reconstruction [augmentation], knee; extra-articular) which is for the ligament reconstruction and has loose body removal inclusive in it.