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2 Different Patella tendon reports

  1. #1
    Default 2 Different Patella tendon reports
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    These patellas is just getting at me this morning! LOL! Anybody knows if there is a code other than unlisted 29999 to be used for case #1 and maybe 27380 for case #2, please let me know? Thanks!

    Case #1
    NAME OF OPERATION: Arthroscopic debridement of undersurface tendon tear with abrasion to tip of patella to stimulate some healing.

    PROCEDURE: The patient was placed on the operating table in supine position. Following adequate anesthesia, he was prepped and draped in a sterile fashion so as to expose the knee area. His knee was then arthroscoped through medial and lateral portals with no tourniquet used. Upon observation, the patellofemoral joint was normal. The medial compartment, lateral compartment, anterior cruciate ligament, and posterior cruciate ligament were all normal. The shaver was placed through a medial portal following which the undersurface fat pad of the patella was resected. The tip of the patella was identified with a spinal needle and confirmed on x-ray. The area of the tear was debrided lightly with the shaver, resecting the undersurface part of the tear. The tip of the patella was also abraded with the shaver to resect back to a bony ossicle.

    Case #2
    NAME OF OPERATION: 1.Diagnostic arthroscopy.
    2. Open resection of degenerative portion of patella tendon.

    PROCEDURE: The patient was placed on the operating table in supine position. Following adequate anesthesia, the knee was examined and found to be stable. He was prepped and draped in a sterile fashion so as to expose the knee area. He was arthroscoped through an anterolateral portal. Upon observation, the patellofemoral joint, medial and lateral menisci, and cruciate ligaments were all normal. A 1 inch incision was made midline over his patella tendon which was split in the midline. The area of his degenerative change was visualized and excised. The inferior pole of the patella was cleaned up using a rongeur to promote some bleeding to the patella. The tendon around this area of defect looked totally nice and clean.

    His tendon was reapproximated with 0 Vicryl, the peritenon with 2-0 Vicryl, and the skin with 2-0 Vicryl. His incision in his patella tendon was about 1.5 cm in length. Upon completion of debridement, there was totally clean tendon which was reapproximated. His skin was closed with Monocryl. A sterile dressing was applied.

  2. #2
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    case # 1 would be 29879

    Mary, CPC, COSC

  3. #3
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    Thanks again Mary! We looked at that one, but felt that the tear part was not included. Maybe with a 22? I know the report does not say much, but that's what I have. This was a high profile athlete, and we were told it had to be perfect, so we choose to do the unlisted.....

  4. #4
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    my thought process is:

    Since it was only lightly debrided, it really doesnt qualify for the 22 modifier. The abrasion arthroplasty would be the 29879 and then the light debridement would bundle as inclusive.

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