Intraoperative medical equipment breakage resulting in additional procedure work

AR2728

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Perryville, MO
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I've read the Medicare policy manual and global surgery package information but need some backup. While performing an arthroscopic knee abrasion arthroplasty, the tip of the microfracture awl broke and unable to be located within the joint. The provider had to perform an arthrotomy in an attempt to locate the broken tip and remove. Based upon all I've read, since this is an iatrogenic complication related to the original procedure and was done at the same operative session, the arthrotomy is not separately billable. I'm questioning myself since this is not the typical "you broke it" and was related to failure of the surgical equipment.
 
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