Question Meniscectomy /Debridement

bharathiT

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Procedure Note : An arthroscopic shaver was used to debride the free edge of the lateral meniscus & debridement of the tear back to a stable rim. Probing of the meniscus confirmed this.

Can we consider this as meniscectomy (Lateral)-29881 or Arthroscopy, knee, surgical; debridement/shaving of articular cartilage-29877?

My opinion as 29877(shaving of articular cartilage)

What are the key elements used for 29881 & 29877.
 

Laxwido

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Piedmont Area Coders, VA
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Procedure Note : An arthroscopic shaver was used to debride the free edge of the lateral meniscus & debridement of the tear back to a stable rim. Probing of the meniscus confirmed this.

Can we consider this as meniscectomy (Lateral)-29881 or Arthroscopy, knee, surgical; debridement/shaving of articular cartilage-29877?

My opinion as 29877(shaving of articular cartilage)

What are the key elements used for 29881 & 29877.
I'm not seeing documentation of a chondroplasty in what is posted above. Was there documentation elsewhere in the Op Note of a cartilage fissure or tear?
It states the "shaver was used to debride the free edge of the lateral meniscus & debridement of the tear back to a stable rim."
Without a diagnosis of cartilage tear, and with the diagnosis of meniscus tear I read this as partial meniscetomy, 29881.

I'd be interested to see the entire note.
Dc
 

iowagirl77

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I agree with Dc. This seems pretty typical of a meniscectomy- they can trim and/or debride the meniscal tear back to a stable rim. There is often a chondroplasty done while they are in there, but it will always be inclusive to the meniscectomy.
 

bharathiT

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Procedure Note :
An arthroscopic probing of the medial menicus tear confirmed an irreparable tear.An arthroscopic shaver was used to debride the loose cartilage fragment back to a stable rim. probing of the meniscus confirmed this.I then put my attention laterally.An arthroscopic shaver was used to debride the free edge of the lateral meniscus & debridement of the tear back to a stable rim. Probing of the meniscus confirmed this.Final arthroscopic photos taken.

This exact operative report. in this documentation, there is no words encountered as trim/countered, still we consider this as 29880?
 

Orthocoderpgu

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Meniscectomy of the Medial and Lateral meniscus was performed. 29880. There is no documentation of articular cartilage 29877. Even if it were, per the 2017 CMS NCCI Surgical Policy Manual 29877 cannot be billed with other arthroscopic knee procedure. Basically speaking 29877 is bundled with the other arthroscopic procedures.
 

bharathiT

Guru
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Salem, Tamil Nadu
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Thanks for your reply.

My doubt is there is no documentation for meniscectomy. Documentation supports for debride the loose cartilage. why we cant code 29877 instead of 29880?
 

Orthocoderpgu

True Blue
Local Chapter Officer
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I re-read the op note that you posted. In the lateral compartment cartilage was debrided. In the medial compartment the meniscus was debrided which is meniscectomy. If you look up 29877 in your CPT book it has a note that if meniscectomy is performed you have to report codes 29880 or 29881. You ask why you can't report 29877 instead? Because the coding instructions tell you not to and meniscectomy of the lateral meniscus is documented. Don't worry, you will get the hang of this.
 
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