Orthopedic Coding Alert

Question For an osteochondral defect in the medial aspect of the left femoral condyle, an arthroscopy was done through standard portals under tourniquet control. There was a lot of synovitis anteriorly, so a sagittal synovectomy was planned. The large osteochondral defect (3cm x 2cm, ½ cm thick) was carefully teased out after expanding the incision. The loose body was removed through a large incision on the medial side and a biopsy was done from the lateral femoral condyle. How do I code for the procedure?

Ohio Subscriber

Answer You report code 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (eg, osteochondritisdissecans fragmentation, chondral fragmentation)). The code is inclusive of synovectomy and this is not reported as a separate procedure. It will not be right to also report 29875 (Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (separate procedure) or 29876 (Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments (eg, medial or lateral)).