Wiki Open Excision Cyst on Knee...

[tsraccntg@gmail.com]

I have a case that I'm struggling with. I work in an ASC and am attempting to code and bill out the following...

PROCEDURES PERFORMED:
1.Open excision of extraarticular portion of ganglion cyst, left knee.
2.Left knee arthroscopy with partial synovectomy and debridement of intraarticular ganglion cyst.

I have 27347 for #1. I have 29874 for the arthro of the intraarticular ganglion cyst. Can I code 29875 for the partial synovectomy as well?

Anyone have any thoughts on this?

Thanks,

Teri

 

[coderguy1939]

Based on the information you've provided, in my opinion it sounds like the surgeon is removing the same ganglion using two different approaches. You can only code one and that would be the open procedure, 27347. If the ganglion had been removed exclusively by arthroscopy, you could consider using the unlisted arthroscopic code 29999 because there is no current code for an arthroscopic excision of a ganglion of the knee. 29874 is for removal of a loose body, not a ganglion.

Regarding the synovectomy, check 27347 in the American Academy of Orthopedic Surgeon GSD manual and review the list of procedures included in 27347. I believe you will find some bundling issues that would prevent you from coding synovectomy. 29875 also has a separate procedure designation which might be probelmatic.

 

[tsraccntg@gmail.com]

Thanks so much for your help!!

Teri