Wiki Arthroscopic Menisectomy and Chondroplasty

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cwilson3333

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Correct me if I am wrong on the coding of this procedure:

Arthroscopy of knee
Chondroplasty of patella
Chondroplasty of Femoral Trochlea
Chondroplasty of Medical Femoral Condyle
Chondroplasty of Lateral Tibial Plateau
Partial Medial Menisectomy
Platelet Rich Plasma Injection

DX: Complex tear of medial meniscus
Chondromalacia patella, femoral trochlea, medial femoral condyle, and
lateral tibial plateau

CPT 29881 only
{seems like so much work, for just 1 code} :(
 
Yes, but that is what Medicare wants. They increased the RVU's to reflect the work of the chondroplasty(s) in all compartments so the surgeon's are getting paid for the work.
 
Chondroplasty

I code it the following:
29881
G0289 (CHONDROPLASTY PATELLA) DX 717.7
G0289 59 ( LATERAL MENISCUS) DIFFERENT COMPARTMENT DX 733.92

0232T is not payable by UHC, AETNA. They consider it as experimental. I the physician dictates it was harvested, I use 38206. It depends if it was injected 20610 or transplanted thru drip 38241.

I've gotten it paid that way.

We're a non contracted asc facility, so You may want to see if the G code is covered under the contracted procedures.
 
You cannot code for a chondroplasty anymore in the same knee joint. The G0289 can only be used when a foreign body is removed from a separate compartment.

The CPT book states "with chondroplasty in the same or separate compartment" so you cannot use the G0289 for any carrier for a chondroplasty with a either the 29880 or 29881. Period.
 
Last edited:
Commercial vs Federal Payers.

I agree with OCD-Coder when you are dealing with a federal payer. However many of your commercial payers will pay for the chondroplasty when done in a separate compartment of the same knee. Check with your payer and see if they follow CMS or CPT guidelines.
In Orthopedics the payer define modifier 59 a differently with sholders and knees.
Federal payers- If the CPT code has a bundling edit which allows modifier 59, the procedure is only applicable for the modifier when the second procedure is done on the oposite side of the boddy. Source NCCI 2013.

Commercial payers-If the CPT code has a bundling edit which allows modifier 59, the procedure with the edit must be done through a separate port site (arthroscopic), or in a different anatomical compartment.
 
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