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Arthroscopically assisted unicompartmental knee

rodenmich

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How would I code an arthroscopically assisted unicompartmental knee?
Would 27446 be accurate?
 

mbort

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can you post the note? Was any portion of the procedure done through an open incision and just visually aided by the scope?
 

rodenmich

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op note

We initially proceeded with the arthroscopy portion of the case. Inferolateral, followed by inferomedial portals were established, diagnostic scope was initiated. Again the medial compartment exhibited grade IV chondromalacia of both the medial femoral condyle, as well as the tibial plateau. It was diffuse. The remaining meniscus was intact. Both the patellofemoral joint and the lateral compartment were free of significant articular cartilage wear. The medial meniscus was preserved. We placed the tibial sizing guide and drilled a guide pin through the proximal metaphysis of the medial tibia. We then used a retrograde reamer to ream our tibial socket, the trial tibial spacer was placed and we had an excellent fit. We then performed a limited medial arthrotomy of the knee, the patella was not everted. We did have excellent exposure of the femur. A sizing guide for the femur was placed as was a guide pin. We were then able to proceed with three reamings that acted as a socket for our femoral component. We then placed the femoral component screw. A trial femur was placed and we had excellent congruency with the articular cartilage. We then removed all trial components. The knee was copiously irriagated. We placed the tibial component with a cemented technique. The femoral component was also cemented in a limited fashion. All instruments were removed, the patellar arthrotomy was closed. I placed the arthroscope one last time to evaluate the components. There was excellent tracking and no impingement. All instruments were removed, the remainder of the incision was closed.
 

mbort

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Based on what you have posted it appears that the majority of the procedure was done through the arthrotomy incision (open) therefore I would use the open unicompartmental code as the scope was mainly used for visualization (except for a small portion of the case which you will have to capture with the 29999 if edits/documentation allow)
 

rodenmich

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Thank you.

Also, the physician I work for is an Orthopaedic Oncologist do you have any recommendations/contacts to assist with coding?
 
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