Arthroscopy knee

dboutwell

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Could someone please give their suggestions for the coding of this surgery.

Operation:
Arthroscopy left knee, Arthroscopic partial Lateral Meniscectomy, removal multiple loose bodies, resection of chondromalacia patella, resection of patellofemoral plica

The arthroscope was introduced and a multiple point exam done. There was very prominent patellofemoral plica that went medially all the way to lateral. There was significant chondromalacia changes involving the patella. The medial meniscus was visualized and probed. There was some ruffling of the edges but no tears. The lateral compartment showed multiple loose bodies. Most of these were removed with the shaver but one was removed with the grasper. The shaver was inroduces and the shaver and VAPR used to resect the patellofemoral plica. The shaver was used to resect the area of chondromalacia involving the patella. The lateral compartment was probed and a free edge tear noted. This was resected with hand instruments and shaver. The wound was then thoroughly irrigated and all bits and pieces seemed to be removed. Steroid was introduced into the joint and instruments removed. Skin edges were infiltrated with Marcaine and closed with nylon.

I am leaning toward codes: 29881, 29874, 29877

Thank you in advance for any advice.
 

dclark7

True Blue
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As of 2012 29877 is bundled with 29881 and no modifier is allowed to unbundle. 29874 should only be used if the loose bodies were larger than 5 mm and/or through a separate incision. There is no mention of the size or a separate incision so it looks to me like 29881 only.
 
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