menisectomy, loose bodies

scooter1

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I know that chondroplasty is now included in 29881 and 29880.
What about loose bodies?

If you have a medial menisectomy and a 1 cm loose body in the lateral compartment, I would ordinarily code 29881 and G0289.

I have had a denial from an insurance carrier who is insisting that the loose body would also be included in the menisecotmy. Any thoughts ?
 

jdemar

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I would appeal it because it is in a separate compartment, note the difference on the op note and be sure to add the -59 modifier to the second procedure.
 

scooter1

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Thank you.
We are appealing the decision. It had the 59 modifier and was linked to the diagnosis code 717.6 ( loose body in knee). But they were insistent with our biller that it was inclusive. So I wondered if anyone else was having this problem. Thank you again
 
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