Orthopedic Coding Alert

Question: Can you help me with the codes for the following procedure?

One of our patients, an 80-year-old male who underwent a unicompartmental arthroplasty, was having some anterior medial knee pain about 50 percent of the time going from a seated to standing position with a snapping sensation. Having failed the conservative therapy of injections and anti-inflammatories, the surgeon planned an elective surgical intervention. The operative note read 'A midline incision utilizing previous  scar was performed and taken down to the fascia. The subcutaneous level was widened. A median parapatellar arthrotomy was performed measuring approximately 2 inches. The medial femoral condyle was visualized showing prominence of the femoral component over the anterior superior medial aspect of the implant. A synovectomy was performed over the eschar on the intra-articular portion of the wound and the femoral component was modified utilizing the diamond tip wheel dresser and smoothed with a bur. It was run through range of motion and showing no impingement. There was a bone wax that was placed over the medial femoral condyle and over the exposed femoral bone. The wound was then irrigated with 3000 mL of sterile saline and closed with #1 Vicryl for the retinaculum, 0 Vicryl for the subcutaneous layer, and 3-0 Monoderm for the skin withSteri-Strips. The knee was injected with 0.5% Marcaine and epinephrine as well as Toradol and Duramorph.'

California Subscriber

Answer: You report codes 27334 (Arthrotomy, withsynovectomy, knee; anterior OR posterior) or 27335 (Arthrotomy, with synovectomy, knee; anterior AND posterior including popliteal area) to describe the synovectomy performed.