Subchondral bone graft surgery code??

jdibble

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Any idea what the CPT code would be for this procedure? I was thinking 27415 but it does not appear to be a open procedure. And 29867 is Arthroscopy, which I don't see in the note! All help is appreciated!



Preoperative Diagnosis
Subchondral fracture lateral femoral condyle/medial tibial plateau

Postoperative Diagnosis
Same

Procedure Performed
Subchondral bone graft augmentation lateral femoral condyle/medial tibial plateau subchondral fracture


Technique/Description of Procedure
Patient brought to operative theater placed supine upon the operating room table and after satisfactory general anesthesia was administered a time-out was carried out confirming operative site with the operative consent. A bump was placed beneath the left hip and C-arm fluoroscopy brought in to visualize the knee in AP and lateral planes. The left lower extremity was then prepped draped usual meticulous sterile fashion from mid thigh to the ankle. After meticulous sterile prepping and draping C-arm was brought in to localize the entry point of the planned cannula insertion. Percutaneous stab incision was made. Utilizing C-arm the bone graft cannula was drilled into the medial cortex into the subchondral region of the medial tibial plateau its position verified both AP and lateral planes. Next a 2nd cannula was passed into the lateral femoral condyle into the subchondral region of the lateral femoral condyle its position verified both AP and lateral planes. With satisfactory position cannulas in place 30 cc of calcium phosphate was injected into the areas. Visualization was augmented with radiopaque fluid . Once the subchondral regions had been filled with the calcium phosphate in the subchondral regions and position verified and documented with x-ray in AP and lateral planes the cannulas were removed and the periosteum regions were then infiltrated with 10 cc 0.5% Marcaine without epinephrine. The wounds were then closed with 4 nylon and dressed with Xeroform 4x4s and a bulky knee dressing placed. Patient was returned to recovery in top procedure well. Estimated blood loss was minimal.


Thanks,

Jodi:confused:
 
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