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old vs new meniscus tears

  1. #21
    Exam Training Packages
    Yes, very interesting that there are so many opinions.
    I bill for anesthesia and we do not have EMR/Op Report access at 3 of our 6 facilities. That being said we had to come up with an acceptable consistent billing guideline. We only bill traumatic 836.x if service is Work Comp, trauma admit, or if anesthesia provider documents traumatic. If no trauma/accident indicator is documented by our provider we bill 717.x. This guideline has survived annual external compliance audits with no ill effects because we are consistent. There have only been a couple times in 18 years that a patient has called & asked us to change to the traumatic dx due to them having "accident" benefits on their health insurance policy--and I haven't had anyone ask me to change from traumatic to non traumatic. (Of course, the traumatic dx is confirmed with the surgeon and/or facility before the diagnosis is actually changed). Just my two cents.

    Julie, CPC

  2. #22
    I purchased the CASCC practicum, should have some time this weeked to see if they have an example of tears on their exercise test. I will let yall know the outcome. I tell you this is the most interesting thread I read so far

  3. Default
    I don't know if this will be of any help, but there is a 2007 Jan-Feb Ortho Coding Alert discussing correct CPT codes for RCR repairs and it essentially states that for most coding situations acute would be for an injury that is less than 3 months old. It goes on to say that unless the surgeon documents an injury of less than 3 months, you'd probably use the the CPT for a chronic RCR rupture. Can this be translated to all joint injuries and DX codes? I don't know. I guess the best thing to do is query the doctor.

  4. #24
    Charm City - Baltimore
    LOL!! Just to throw out another number - I was always told the if the injury is 6 months or less it is Acute and anything older than that is Old/Chronic! I have used that guideline and I am trying to find my paperwork on it - but thankfully, most times, our surgeons state in the note whether or not it is degenerative or a recent injury.
    Crystal, CPC, CCS-P

  5. #25
    I know this is an older thread but to through my two cents in what if the doc reports medial meniscus tear and also has underlying degenerative arthritic changes in medial compartment.

    so now we have we post both???

  6. #26
    Wow, I was taught the complete opposite. I was taught the timeline from acute to chronic is approx 3 mos.

    If I have a patient who has a 7 month old injury then I would code 717.xx, the code is not just a "degenerative" code the definition includes "old tears" the patient may not even have any DJD but the tear is still old.


  7. #27
    Anyone have a definitive answer????????????

  8. #28
    Columbia, MO
    Quote Originally Posted by lgentry View Post
    I know this is an older thread but to through my two cents in what if the doc reports medial meniscus tear and also has underlying degenerative arthritic changes in medial compartment.

    so now we have we post both???
    is the tear due to the degenerative changes?

    Debra A. Mitchell, MSPH, CPC-H

  9. #29
    he just states both, patient has degenerative and a tear... and he states it several times in op report

  10. #30
    for this scenario, if there is no mention of injury in the op report, I would code the 717.X series. Check the H & P to see if there is more info as well. Chronic pain is a good indicator
    Mary, CPC, CANPC, COSC

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