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Arthroscopic and Open Knee Surgery

coderguy1939

Guest
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Doctor started knee surgery arthroscopically and found a loose body that was so large that he switched to open surgery to remove it, then reinserted the scope to complete diagnostic part of the surgery. CCI does not exclude coding both, but AAOS guidelines indicate 29870 as included in 27331. I'd appreciate some help with this. Thanks.
 

mbort

True Blue
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2,338
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I would use the 27331 as primary code, then the 29870. For the 29870 I would use the V code (convert to open) as well as any other diagnoses such as synovitis, DJD, chondromalacia or anything else he/she may have documented that was seen during the diagnostic portion of the case.
 

amitjoshi4

Guru
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27331 is the only code to be coded here. Diagnostic Arthroscopy is inclusive to it. Open Px are always reportable in preferance if the same px is done via arthroscopic or open method. The best way is to put Dx code V64.43 to make it more elaborate.

Thank You
 

mbort

True Blue
Messages
2,338
Location
ENGLEWOOD/DENVER
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27331 is the only code to be coded here. Diagnostic Arthroscopy is inclusive to it. Open Px are always reportable in preferance if the same px is done via arthroscopic or open method. The best way is to put Dx code V64.43 to make it more elaborate.

Thank You
In most instances you are correct Amit, however in this particular instance, the dx arthroscopy does not bundle per the NCCI edits.
 
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