Orthopedic Coding Alert
Consider Graft Type for OCD Repair
Pennsylvania Subscriber
Answer: The answer depends on which type of grafting your surgeon used for the repair. If she used an allograft, you should report 27415 (Osteochondral allograft, knee, open) for the procedure.
If your surgeon used autograft, you-ll have to report an unlisted-procedure code (27599, Unlisted procedure, femur or knee) because 27415 only applies to claims for OCD repair using allograft. Remember to ask the surgeon to select a -compare- code so you can set your fee, and also to send the physician's op report along with your claim to support billing the unlisted-procedure code.
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