Orthopedic Coding Alert
Stay With One Knee Compartment Code
Question: The surgeon excised a flap tear and completed a partial synovectomy in the medial compartment. He also performed partial synovectomy, chondroplasty, and excision of meniscus tear in the lateral compartment. He noted several codes but I don't think we can report everything. What's the correct choice? New Jersey Subscriber Answer: You're correct -- your surgeon is trying to submit too many codes when you only need 29880 (Arthroscopy, knee, surgical; with meniscectomy [medial AND lateral, including any meniscal shaving). Explanation: The synovectomies in the medial and lateral compartments and the chondroplasty in the lateral compartment are included with the meniscectomies. Therefore, codes such as 29875 (... synovectomy, limited [e.g., plica or shelf resection] [separate procedure]) and 29887 (... drilling for intact osteochondritis dissecans lesion) are unnecessary. Include the diagnoses for medial and lateral meniscus tears. For the medial meniscus, choose from: • 717.0 -- Internal derangement of knee; old bucket handle tear or medial meniscus • 717.1 -- ... derangement of anterior horn of medial meniscus • 717.2 -- ... derangement of posterior horn of medial meniscus • 717.3 -- ... other and unspecified derangement of medial meniscus. You also have several choices for coding the lateral meniscus tear: • 717.40 -- Derangement of lateral meniscus; derangement of lateral meniscus, unspecified • 717.41 -- ... bucket handle tear of lateral meniscus • 717.42 -- ... derangement of anterior horn of lateral meniscus • 717.43 -- ... derangement of posterior horn of lateral meniscus.
Orthopedic Coding Alert
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