arthroscopic osteophyte excision of tibia

Lindseywingate1990

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Lake View, Alabama
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i am coding a procedure that includes:

arthroscopic medial menisectomy 29881

arthroscopic osteophyte excision of tibia.??

it reads.....the medial compartment was visualized first. this was arthritic. there was an osteophye in the middle of the tibial condyle that was planes smooth. there was some degenerative fraying of the meniscus which was debrided but only represented 30% partial menisectomy. there were condral changes in both the tibial and femoeal sides. these were debrided. the femoral notch was visualized there was a huge tibial spine osteophyte that impinged and prevented full extension. i elected to excise this. this was done with a pituitary rogour and a burr back to smooth base this was just anterior to the
acl



thanks in advance for any advice! :)
 

angieboore

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Hi,

I was wondering if you anyone ever figured this out.....

I'm relatively new to ortho coding and have the exact same situation.

Thanks in advance.

Angie
 
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Parrish, FL
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We just got an AMA response for this very question!

June 25, 2020 Dear XXX,
This is written in response to your Electronic Inquiry (EI) #12542. Please note and as stated in the CPT Network, Disclaimer Subscriber Agreement, “Operative reports, medical records, or any other materials should not be submitted and are not accepted. Electronic inquiries to CPT Network should contain one brief clearly stated question per electronic inquiry that specifically addresses your coding need.” In addition, “CPT® Network reserves the right to debit Member or Subscriber's accounts commensurate with research required for complex inquiries or for follow-up questions.” From a CPT coding perspective, based solely upon the information provided in your inquiry, and the excerpted information from the American Academy of Orthopaedic Surgeons, Code X, code 29880, Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed, services included in the global service package are: • local infiltration of medication(s), anesthetic, or contrast agent before, during, or at the conclusion of the operation • suture or staple removal by operating surgeon or designee • surgical approach, with necessary identification, isolation, and protection of anatomic structures, including hemostasis and minor skin scar revision • obtaining wound specimen(s) for culture • wound irrigation • intraoperative photo(s) and/or video recording, excluding ionizing radiation • intraoperative supervision and positioning of imaging and/or monitoring equipment by operating surgeon or assistant(s) • insertion, placement, and removal of surgical drain(s), re-infusion device(s), irrigation tube(s), or catheter(s) • closure of wound and repair of tissues divided for initial surgical exposure, partial or complete • application of initial dressing, orthosis, continuous passive motion, splint, or cast, including traction, except where specifically excluded from global package • synovial resection for visualization • diagnostic arthroscopy of knee (eg, 29870) • manipulation under anesthesia (eg, 27570) Services not included in the global service package: • conscious sedation, regional block(s), Bier block(s) • supplies and medication (eg, code 99070, HCPCS Level II codes) • insertion, removal, or exchange of nonbiodegradable drug delivery implants (eg, 11981-11983) • arthroscopic removal of loose (nonmeniscal) or foreign bodies greater than 5 mm or through a separate incision (eg, 29874) • arthroscopic abrasion arthroplasty, multiple drilling or microfracture (eg, 29879) • arthroscopic synovectomy (eg, 29876) Medicare global fee period: 90 days Based on the above information, and in response to your specific question, code 29880 would be reported for the entire procedure described in your inquiry with modifier 22, Increased Procedural Services, appended. The chondroplasty is included, and ostectomy of the tibial spine, would be covered by appending modifier 22 for the additional work, and not separately reported. Please note that you account will be charged one additional credit for this inquiry. Thank you for using the CPT Knowledge Base, and we hope this information is of assistance to you. CPT Education and Information Services

Hope this helps,
Lisa CPC, CIRCC
 
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