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Plica resection with meniscectomy

  1. Smile Plica resection with meniscectomy
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    Does anyone have written documention that you can billed a plica resection in addition to meniscectomy when it is performed in a seperate comparment? (ie: plica resection done in patellofemoral compartment with mensicectomy done in the medial compartment) I know that I have been told this in several conferences but I am unable to location the documentation. We are trying to appeal a denial from workmans comp.

    Also, if anyone has documentation if a carticel biopsy can be billed seperately that would be great.

    Thanks.

    Jodi Howard, CPC

  2. Default
    Quote Originally Posted by jhoward77 View Post
    Does anyone have written documention that you can billed a plica resection in addition to meniscectomy when it is performed in a seperate comparment? (ie: plica resection done in patellofemoral compartment with mensicectomy done in the medial compartment) I know that I have been told this in several conferences but I am unable to location the documentation. We are trying to appeal a denial from workmans comp.

    Also, if anyone has documentation if a carticel biopsy can be billed seperately that would be great.

    Thanks.

    Jodi Howard, CPC

    For your appeal you just have to explain and send them documentation on how there are 3 different compartments of the knee and so they should not be bundled together. Also did you put a modifier 59 on the 29875 (plica)because per CPT book that is a separate procedure so you have to put modifier 59 on that.
    Just specify what was done on what compartment. And underline it in the op note.
    This one should be easy to win.
    Good luck,
    Melissa
    p.s. not sure about the biopsy.

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