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Help in coding

  1. Default Help in coding
    Medical Coding Books
    proc: Lt knee arthroscopy w/ posteromedial and lateral menisectomies and separate anterior patellar bony mass excision

    The inferomedial and infraportals were established through which the knee was examined and noted to have medicla and lateral meniscal tears. This was smoothed down to stablize edges using the meniscal shaver. The samll plica was removed anteriorly and a small area of chondromalacia under the kneecap was also debrided. Attention was then turned to the anterior patella througha 2cm incision. A large suprapatellar mass was removed , which appeared to be a large gouty tophus.
    I coded 29881, question would I code the mass as 27619,, Im kinda thrown off by the DX patellar bony mass excision. Help would be apppreciated

  2. #2
    I would code it, it is a separate incision.

  3. Default
    I agree, due to the separate incisions and also 2 different knee compartments

  4. #4
    I would use 29880 instead of 29881, since he did medial AND lateral menisectomies. Also not sure if 27619 is the correct code, since that is for leg/ankle, and not knee area?

  5. #5
    I agree with martn

    Mary, CPC, COSC

  6. Default
    Thanks all for the replys, I was concerned about the mass excision, wondering if the mass excision (gouty tophi) would be considered a bony tissue mass or a soft tissue mass?

  7. #7
    he calls it a patellar "bony" mass

  8. Default
    yes, the reason for my confusion is that he gives a DX of anterior patellar bony mass, in the body of the dictation he states it to be a large suprapatellar mass. Today I queried him and he said to use CPT 27350, yet when I called his office they told me he coded it 27619, Im just about ready to close my eyes and just pick, just kidding


  9. #9
    From Tophus: A nodular mass of uric acid crystals. Tophi are characteristically deposited in different soft tissue areas of the body in gout. The word tophus comes via Latin from the Greek tophos meaning a porous volcanic stone. In chronic (tophaceous) gout, nodular masses of uric acid crystals (tophi) deposit in different soft tissue areas of the body. Even though tophi are most commonly found as hard nodules around the fingers, at the tips of the elbows, and around the big toe, tophi nodules can appear anywhere in the body. They have been reported in unexpected areas such as in the ears, vocal cords, or around the spinal cord!

    I would use 27619..

  10. Default
    27328 is for thigh and knee area.

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