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29879? G0289?? Tia

  1. #1
    Default 29879? G0289?? Tia
    Medical Coding Books
    I have 29876 for the synovectomy
    29881 for menisectomy
    29879?
    G0289?
    Could please use some input/thoughts I am still fairly new to Ortho.

    TIA
    Melissa Bedford,CCS,CPC


    PREOPERATIVE DIAGNOSIS:
    Left knee synovitis, possible meniscal tear and arthritis.

    POSTOPERATIVE DIAGNOSES:
    Left knee pain, synovitis with inflamed plica, medial femoral
    condyle articular cartilage injury, mild arthritis, posterior
    horn tear of the medial meniscus, multiple cartilaginous loose
    bodies greater than 10.

    PROCEDURE:
    Arthroscopic examination with synovectomy in all compartments,
    removal of multiple loose bodies, abrasion arthroplasty with
    microfracture of medial femoral condyle, and partial medial
    meniscectomy.

    SURGEON:


    ANESTHESIA:
    General LMA.

    ESTIMATED BLOOD LOSS:
    Minimal.

    COMPLICATIONS:
    None.

    TOURNIQUET TIME:
    About 29 minutes.

    PROCEDURE:
    After taking informed consent, the patient was brought to the
    operating room, placed on operating room table in supine
    position. After administration of general LMA anesthesia,
    time-out was performed. The patient was identified,
    appropriate biopsy site was marked and he received appropriate
    antibiotics. Next, a tourniquet was placed on the proximal
    thigh and the skin was prepped and 0.5% lidocaine with
    epinephrine was placed in the knee joint. Next, the left leg
    was sterilely prepped and draped in a routine manner. An
    anterolateral arthroscopy portal was then made and
    arthroscopic examination of the joint was performed.
    Examination of the suprapatellar area showed inflammation of
    the synovium. The patellofemoral joint was normal in
    appearance. The medial gutter showed a thickened inflamed
    medial plica and some cartilaginous loose bodies. The medial
    joint was examined. It was on a very thickened, inflamed
    synovium which made visualization of the medial joint
    difficult and spinal needle was used to help make an
    anteromedial portal and inflamed synovium was debrided to help
    with visualization of the medial joint. There was some
    bleeding noted and the tourniquet was inflated. Next, he was
    noted to have about 1 cm area of exposed subchondral bone and
    fibrillated articular cartilage. There were some loose bodies
    noted here also. There was a tear at the insight edge of the
    posterior horn of the medial meniscus. The notch area was
    examined and the ACL and PCL were intact as was the ligament
    of mucosum. Next, with the aid of a punch and shaver, partial
    medial meniscectomy was performed. Next, the shaver was used
    to debride the end of the medial femoral condyle down to
    stable cartilage and bone and microfracture was done on the
    area of articular cartilage injury. Good microfracture was
    noted. Next, the lateral side was addressed. The meniscus
    was probed and noted to be stable. There were a few small
    loose bodies noted here and lateral gutters were examined.
    There was a large collection of loose bodies noted there also.
    Next, with aid of the shaver, the inflamed plica was noted,
    inflamed synovium was debrided in all compartments and the
    loose bodies were also removed in both the gutters and joint
    in the suprapatellar area, third debridement of loose bodies
    were noted. No further loose bodies were noted. The back of
    the knee was palpated to help loosen any of the loose bodies
    that might be posteriorly. Third debridement was performed.
    Next, the arthroscope was removed from the knee joint.
    Steri-Strips used to approximate the skin edges and the
    portals and joint were infiltrated with 1% lidocaine. A
    sterile dressing was applied and the patient was transferred
    to recovery in stable condition.

  2. #2
    Default
    Please, anyone??

  3. #3
    Default
    Is this for a federal payer or a commercial payer?

  4. #4
    Default
    Medicare is what the patient has.

  5. #5
    Default
    I like 29881, 29879, and 29875-59 because the provider performed medial meniscectomy, microfracture technique, and limited synovectomy as he/she debrided the other compartment for visualization purposes. I wouldn't code G0289 because it is for a separate compartment and it looks like it would be included per the note.

    Lekisha Bryant, CPC, COSC

  6. #6
    Default
    Got it about the G code. Thanks for explaining the synovectomy. I will master this I am determined to
    Melissa Bedford,CCS,CPC

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