Microfracture to promote healing

[MKOCHICK]

I have a provider that does a Microfracture (29879) to promote healing in the knee after doing a meniscectomy/meniscus repair. Can I code this since it is used to promote healing? Or would this be a bundled procedure?

 

[amyjph]

It depends on the documentation. There is no edit between 29879 & 29880/1/2, but there is with 29879 & 29883. It has to be really clear that it wasn't just chondroplasty. It's a debate-able coding choice when it's to "promote healing" and that's all they say.

This is an old article link (don't use the other guidance) but this concept is the same when it comes to microfracture: https://www.beckersspine.com/orthop...coding-pitfalls-impacting-an-ascs-bottom-line
"Documentation requirements: According to the American Academy of Orthopaedic Surgeons, "The abrasion arthroplasty or microfracture code (29879) is appropriate when the procedure exposes bleeding subchondral bone." Documentation must support this."

 

[Orthocoderpgu]

I have a provider that does a Microfracture (29879) to promote healing in the knee after doing a meniscectomy/meniscus repair. Can I code this since it is used to promote healing? Or would this be a bundled procedure?

I do agree with what Amy has said, she always gives great advice. Microfracture is generally used to repair smaller chondral defects. The doctor drills down through the cortical bone until there is bleeding. This fills the defect and basically hardens. After meniscectomy or meniscus repair the idea is that the microfracture "helps" in the repair process, but is not really a repair procedure in and of itself at least in this situation. Kind of like the cherry on top of a sundae. If you look at the diagnosis codes that support performing 29879, meniscus tears are not listed. Since this is being done just to support the actual repair, I don't see it as something that would be reported separately.

diagnosis codes, diagnosis coding