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Arthroscopy converted to open

  1. #1
    Default Arthroscopy converted to open
    Medical Coding Books
    Doctor did arthroscopic debridement of a 3 fragment intraarticular fracture of the distal radius. In the op report he states "the fractur e was not mobile enough to allow adequate arthroscopic aided reduction" so "due to the need for improved reduction, the procedure was then moved to open reduction and internal fixation. In this instance, would you just code the 25609 or include the arthroscopic debridement? Thanks.

  2. #2
    Greater Pittsburgh
    you can bill for the arthroscopic debridment w a -51 modifier and add the dx code v64.43 - arthrosopic surgical procedure converted to open procedure .
    jdemar, CPC, CMA

  3. #3
    I disagree. If the case was converted to open, you code the most extensive procedure per CPT guidelines which is the open. With that being said, you may want to look at 11011/11012 as well to see if you have documentation to support either of those in addition to the ORIF

    Mary, CPC, CPC-ORTHO
    Last edited by mbort; 12-30-2008 at 10:36 PM. Reason: typo

  4. #4
    Doctor did arthroscopic debridement before he attempted an arthroscopic repair. Would 29846 be appropriate along with 25609, Mary?

  5. #5
    Quote Originally Posted by coderguy1939 View Post
    Doctor did arthroscopic debridement before he attempted an arthroscopic repair. Would 29846 be appropriate along with 25609, Mary?
    the 29846 would not be appropriate because that code is for excision and/or repair of the TFCC and/or debridement.

    I replied to your private message. If you send me the op note or post it here, I will take a look to see if there is anything else you can capture.


  6. Default
    I agree with Mary. Only code the open procedure, but verify your documentation. You may justify coding 11011/11012.


  7. #7
    Thanks for all the input.

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