Excision loose body prepatellar bursa


Hazelwood, MO
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My doc did an open removal of a loose body from the prepatellar bursa. I looked to 27331 first, but he didn't actually go into the knee joint to remove it. Then I checked 27372 but that is listed as removal of foreign body from the knee area. Would this be an unlisted code 27599? He sent the specimen off to pathology but we don't have a report back yet. Thank you for any help you have to offer.

"We made a small, transverse incision about 1 cm in length and spread it out to identify the tannish grey loose body. It did not feel like cartilage; it was rather rubbery, scar like but shaped much like a jelly bean. I dissected around it with a hemostat and used scissors to snip it free from surrounding tissue. It came out nicely. The specimen measured about 1 cm in length x 0.5 cm in width and was sent to Pathology."


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People with Prepatellar Bursitis of a chronic nature will sometimes get "pieces" trapped in the bursa. I used to call the "gristle" for lack of a better term. These can be tender, and may slide around in the bursa. Sometimes they are completely free/loose in the bursa, but more often have some sort of "stalk" that attaches them to the bursal lining/wall, as in your case. The Path Report will probably be read out as chronic scar tissue, maybe with some synovial element. As for coding the procedure, since he did not enter the joint (arthrotomy), and was restricted to the bursa, then the 273 _ _ code would not apply. He did not do a complete Prepatellar Bursectomy (27340), I would probably not use this either. Since the "mass" removed was "sort of a tumor" and was in the bursa, which is in the subcutaneous tissue, you might consider 27327. If you are uncomfortable with that, go with 27559, Unlisted Procedure. Be sure to send the documentation to support your claim.

Hope this helps.

Respectfully submitted, Alan Pechacek, M.D.