CPT for osteochondritis dessecans lesion with screw fixation

Orthocoderpgu

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This lesion is on the medial femoral condyle. Normally the lesion is repaired using plugs. However, this time the physician first used a K-wire to hold the bone down, and then over-drilled a screw to hold the bone down. What CPT would you use for this? Any thoughts would be helpful.
 

AlanPechacek

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Without the Operative Report to work from, this is hard to answer. It was probably done Arthroscopically, so I would use an Arthroscopic Procedural Code. From what you describe, he did a Drilling (K Wire placement), then an Internal Fixation Procedure. At issue is whether the lesion was completely "stable" or mildly "unstable" (slightly loose and wobbly, but not completely displaceable or mobile). In essence, he did an "in situ" fixation of the lesion, for which I would recommend 29887: Drilling for intact osteochondritis dissecans lesion with internal fixation.

Respectfully submitted, Alan Pechacek, M.D.
 
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