29879, 29880, 29877, 29874

drr66

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We need clarification again on this subject. Op note states:

1. Partial medial and lateral menisectomy.
2. Superficial chondroplasty patellofemoral and medial compartment.
3. Microfracture chondroplasty medial femoral condyle.
4. Multiple loose bodies removed ranging in size from 5 to 10 mm present in the suprapatellar pouch and all three compartments as well (patellofemoral, medial and lateral, as well as the medial and lateral gutters.)

Surgeon wants to use 29880, 29879, 29877 and 29874 X 3. We (the coders) are thinking he should be using 29880, 29879 and 29874 X 1 (since greater than 5 mm)

All opinions greatly appreciated!!!!
 

mbort

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We need clarification again on this subject. Op note states:

1. Partial medial and lateral menisectomy.
2. Superficial chondroplasty patellofemoral and medial compartment.
3. Microfracture chondroplasty medial femoral condyle.
4. Multiple loose bodies removed ranging in size from 5 to 10 mm present in the suprapatellar pouch and all three compartments as well (patellofemoral, medial and lateral, as well as the medial and lateral gutters.)

Surgeon wants to use 29880, 29879, 29877 and 29874 X 3. We (the coders) are thinking he should be using 29880, 29879 and 29874 X 1 (since greater than 5 mm)

All opinions greatly appreciated!!!!

I agree with you (somewhat) but what I would do for the
Patellofemoral compartment (depending on his superficial documentation) is use the 29877 instead of the 29874 (RVU's higher for 29877 I believe) for the chondroplasty/loose body in the patellofemoral joint (since we can't have both). If the superficial chondroplasty documentation stinks, then I would go with the 29874.

My two cents :)
Mary,CPC,CPC-ORTHO
 

drr66

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Wouldn't the 29877 be inclusive of the 29879 regardless of different compartment location?
 

mbort

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For the 29879 (which can be billed per compartment, up to three times) was in the medial compartment, you can still use the 29877 for the patellofemoral compartment. You will have to use the 59 because 29877 is inclusive to everything else.
 

drr66

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But when we look at Code-X 29877 is said to be inclusive of 29879 with no exceptions but can be coded with modifier 59 for patellofemoral compartment if you look under 29880.

Our other question is can 29874 be charged per compartment especially if each compartments loose body or bodies is greater than 5 mm?

Is there somewhere we can find documention on what codes of the knee can be charged per compartment?

Appreciate all the help!!!
 

mbort

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But when we look at Code-X 29877 is said to be inclusive of 29879 with no exceptions but can be coded with modifier 59 for patellofemoral compartment if you look under 29880.

Our other question is can 29874 be charged per compartment especially if each compartments loose body or bodies is greater than 5 mm?

Is there somewhere we can find documention on what codes of the knee can be charged per compartment?

Appreciate all the help!!!
I'll fax you the documentation--printing now and will be on its way in a few minutes :)
 
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