gmsmith2018
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I need help with coding this procedure. It is one part of the surgery which includes arthroscopic loose body removal and arthroscopic chondroplasty (I know those two bundle and I am using 29877 for that part). Does anyone have experience or advice for this?
"... I utilized an 18-guage spinal needle to establish a separate anteromedial portal and immediately it became evident that the entire anterior fat pad was totally calcified and what was seen on the preoperative x-ray and MRI was not truly loose anteriorly, but calcification and there was no way I could manipulate the arthroscope at all to look through the rest of the joint and so this calcification would have to be removed first and so attention was directed toward formal arthrotomy.
A 3cm longitudinal incision was made medially and carried down through subcutaneous tissue with hemostasis obtained as necessary with electrocautery. Retinaculum was incised alongside the medial edge of the patellar tendon to enter the joint. I then mobilized with an elevator the large calcific deposits present in the fat pad and they were excised and saved to actually show the patient. A rongeur was used to remove some smaller fragments. Once this was done, the retinaculum was exposed with #0 Vicryl and attention was directed back to use of the arthroscope. ..."
I was looking at 27334, but I'm not sure that is correct. Thanks in advance for any advice
"... I utilized an 18-guage spinal needle to establish a separate anteromedial portal and immediately it became evident that the entire anterior fat pad was totally calcified and what was seen on the preoperative x-ray and MRI was not truly loose anteriorly, but calcification and there was no way I could manipulate the arthroscope at all to look through the rest of the joint and so this calcification would have to be removed first and so attention was directed toward formal arthrotomy.
A 3cm longitudinal incision was made medially and carried down through subcutaneous tissue with hemostasis obtained as necessary with electrocautery. Retinaculum was incised alongside the medial edge of the patellar tendon to enter the joint. I then mobilized with an elevator the large calcific deposits present in the fat pad and they were excised and saved to actually show the patient. A rongeur was used to remove some smaller fragments. Once this was done, the retinaculum was exposed with #0 Vicryl and attention was directed back to use of the arthroscope. ..."
I was looking at 27334, but I'm not sure that is correct. Thanks in advance for any advice