Open or Scope procedure

kelliey

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Local Chapter Officer
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Fruita, CO
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Which code is correct? Open 27403 or Scope 29882? Operative documentation states access as " A longitudinal incision was made over the lateral aspect of the knee just posterior to the lateral collateral ligament". The inside out technique requires an incision. After which surgeon reports "I then placed the arthroscopy back in the knee" If access to surgical site is through an open incision then the procedure is considered open? The incision did not open to the joint, only provided access to it. The actual bucket-handle tear repair of the lateral meniscus was performed through the scope.
 

AlanPechacek

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Your physician appears to be doing an Arthroscopic Lateral Meniscal Repair (29882). It also appears he was doing an Inside Out technique were his sutures are passed through the meniscus from inside the joint, then going to the outside the joint to be tied. The extra incision he describes would be an Accessory Incision done to provide protection of structures outside the joint, particularly the Peroneal Nerve, and allow him to tie his sutures just outside the joint capsule. This still makes/keeps the procedure as an Arthroscopic procedure only.

Respectfully submitted, Alan Pechacek, M.D.
icd10orthocoder.com
 
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