Answer Cyclops Lesion Debridement w/ notchplasty

cclarson

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For the arthroscopic debridement of a cyclops lesion, I'm leaning towards using 29884 for the main procedure. Now, the doctor claims that they also did a "minimal notchplasty", would I code this separately or would this bundle? Also, if I do code this separately, what would best fit as the cpt? 29877? Any help would be deeply appreciated. :)

Here is the portion of the report where it is mentioned:

"After surgical time out, the lateral portal was made through the old scar and a medial portal was made under direct visualization. Her leg had been Esmarch exsanguinated and the tourniquet inflated prior to prepping and draping.

Routine arthroscopy was performed. The suprapatellar pouch showed some hemosiderin staining but was otherwise unremarkable. The patellofemoral joint showed grade 2 change of the trochlea with some grade 2 change of the patella. The notch showed an obvious large cyclops lesion. Using the shaver, the cyclops lesion was excised and a healthy appearing ACL was noted. After excising the cyclops lesion, she had full hyperextension. To be safe, I did a little bit a notchplasty superiorly to make sure there was not any impingement. The medial compartment was pristine. The lateral compartment was pristine.

The procedure was completed. The portals were closed with nylons. She was dressed with sterile gauze and a compression wrap. She was awakened and taken from the OR in stable condition."
 

Orthocoderpgu

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If a Cyclops lesion is removed during synovectomy (which I have never seen but others have) it would be included with 29875. That is not the case here so 29884. Regarding the notchplasty and 29877. You need to download a copy of the CMS NCCI surgical policy manual. It states that 29877 cannot be billed with any other arthroscopic code. All debridement of the knee is bundled when any other arthroscopic procedure is performed.
 
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