mfranks
Contributor
Doctor is stating that he did a Medial and Lateral Meniscectomy and should be coded as a 29880. In looking at it I beleive its a 29877. Any feedback is appreciated. Op note is below.
Fat pad was moved out of the way and under direct visualization, the medial portal was made. I immediately recognized that there was a large defect in the medial femoral condyle. This was in the region of 1-1.5 cm. I elected to perform a forage or chondroplasty. I then drew my attention to the medial meniscus, which showed a degenerative tear at the three-o'clock position. This was debrided back to a stable edge. I fully inspected the meniscus above and below and did not note any other tears. The state of the medial tibial plateau was good with grade 2 chondromalacia. Moving into the trochlear notch, I noted that there was a similar defect in the notch and performed a similar chondroplasty in this region, debriding the loose articular cartilage. Moving into the notch of the femur, I noted that the posterior cruciate ligament and anterior cruciate ligament both showed excellent integrity with no fraying whatsoever. Moving into the lateral jointline, I noted that there was indeed, a tear of the lateral meniscus in and around the nine-o'clock position. This was more degenerative in nature and was debrided back to a stable edge. I then thoroughly inspected the under and over-side of the meniscus in the region of the posterior horn, where there was a horizontal tear. Rather than finding a horizontal tear, I actually found an undersurface radial tear, which was less than 2 mm. This was quite a small tear and I did not think that it was worth trying to repair this as I believe the patient would lose a considerable amount of the play of her meniscus, as well as the overall diameter of the meniscus. I believe that such a small tear would not propagate a further tear and I think that more of what was locking up her knee were the multiple loose bodies, which I found in all three compartments of her knee. Some of these loose bodies were as large as 1 cm in length
Fat pad was moved out of the way and under direct visualization, the medial portal was made. I immediately recognized that there was a large defect in the medial femoral condyle. This was in the region of 1-1.5 cm. I elected to perform a forage or chondroplasty. I then drew my attention to the medial meniscus, which showed a degenerative tear at the three-o'clock position. This was debrided back to a stable edge. I fully inspected the meniscus above and below and did not note any other tears. The state of the medial tibial plateau was good with grade 2 chondromalacia. Moving into the trochlear notch, I noted that there was a similar defect in the notch and performed a similar chondroplasty in this region, debriding the loose articular cartilage. Moving into the notch of the femur, I noted that the posterior cruciate ligament and anterior cruciate ligament both showed excellent integrity with no fraying whatsoever. Moving into the lateral jointline, I noted that there was indeed, a tear of the lateral meniscus in and around the nine-o'clock position. This was more degenerative in nature and was debrided back to a stable edge. I then thoroughly inspected the under and over-side of the meniscus in the region of the posterior horn, where there was a horizontal tear. Rather than finding a horizontal tear, I actually found an undersurface radial tear, which was less than 2 mm. This was quite a small tear and I did not think that it was worth trying to repair this as I believe the patient would lose a considerable amount of the play of her meniscus, as well as the overall diameter of the meniscus. I believe that such a small tear would not propagate a further tear and I think that more of what was locking up her knee were the multiple loose bodies, which I found in all three compartments of her knee. Some of these loose bodies were as large as 1 cm in length