29885

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Please help with the correct/appropriate CPT code for the procedure bellow; DX Code is CYCLOPS LESION ANTERIOR ~1CM IN SIZE and the surgery was done by Arthroscopy.

THE ACL GRAFT FIBERS WERE RESECTED WITH A MECHANICAL SHAVER TO REVEAL THE FEMORAL AND TIBIAL TUNNELS. THE PREVIOUS TIBIAL INCISION WAS USED AND THE SITE OF THE PRIOR TIBIAL TUNNEL WAS PALPATED. A GUIDE PIN WAS INTRODUCED BY HAND AND VISUALIZED IN THE KNEE JOINT WITH THE SCOPE AND CLAMPED WITH A KOCHER. SEQUENTIAL REAMING WAS PERFORMED UP TO A SIZE 12 WITH GOOD CHATTER TO BLEEDING BONE. THE SHAVER WAS USED TO DO SOME ADDITIONAL DEBRIDEMENT AT THE INTRAARTICULAR APERTURE. THE BONE DOWEL OF 12X31MM WAS ADVANCED OVER THE GUIDE PIN AND GENTLY IMPACTED WITH A BONE TAMP UNTIL THE BULLETED END WAS VISIBLE AND LEVEL WITH THE NATIVE BONE AT THE OPENING. THE GUIDE PIN WAS REMOVED AND THE REMAINING VOID AT THE TIBIAL APERTURE WAS FILLED
WITH 1CC OF DBM PUTTY. THE WOUND WAS IRRIGATED AND CLOSED WITH 0 VICRYL, 2-0 MONOCRYL,AND 3-0 NYLON.

Thank you!
 

Orthocoderpgu

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Um, this is not treatment of a cyclops lesion. A cyclops lesion has nothing to do with bone. This patient had a prior ACL which has failed, and the physician is most likely preparing to perform a repeat ACL procedure. In order to do that the surgeon is filling in the tibial tunnel with a bone graft and DBM. This will take several weeks for the bone in the tunnel to harden, but the doctor will be able to go back and re-drill the tunnels for a new ACL. Usually both the tibial and fibula tunnels are prepared this way. A cyclops is formed mostly out of the remnants of the ACL itself which the doctor removed. If just the cyclops is removed it would be reported with 29884. The lion share of this work was done to prepare for the future ACL which would be reported with an unlisted code. There is also no mention of finding a cyclops lesion once the physician got into the knee, but no doubt they expected one especially with the ACL failing.
 
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Orthocoderpgu

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Thank you! I agree going with 29884. I truly appreciated your help.
I think you read this wrong. In this case the doctor did not remove a cyclops lesion. It's documented that the ACL fibers were resected. I also stated that the lion share of the work was preparing the bones for the future graft and that it would be coded unlisted. You don't want to bill 29884 as this code is not supported and 99% of the work was preparing the bone for future tunnels to be drilled.
 
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