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the arthroscopic OCD microfracture of the elbow

  1. Default the arthroscopic OCD microfracture of the elbow
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    I was wondering if someone can help me to code the arthroscopic OCD microfracture of the elbow. I know that I should use the unlisted code 29999 for this since there is no code that properly describes this, but I was wondering if I can code it with limited debridement 29837 or would it be considered as incidental?

    Here's part of the op report:
    A debridement of the humeral head capitellar defect was then performed. This was done from both anterior and posterior compartments. After this was accomplished, the defect could clearly be approached more easily from the posterior compartment. After this was debrided and loose overlying cartilage was removed, the patient was noted to have a fragmented softened cartilage scar in the area. There was no obvious bony attachment below this. After this was accomplished, a microfracture drilling was performed through the remaining desiccated cartilage in the area of the capitellar defect.

  2. Default Ocd elbow

    We don't have a direct code for microfracture elbow, neither are we willing to code unlisted code. In such case I would definitely go for 29837, extensive debridement elbow.

    Dr. Poonam

  3. #3
    Our office uses the unlisted code with 29879 as a comparison code with a letter explaining that there is no code for the elbow and that it is similar to that code and send the operative report. With 29879 debridement/chondroplasty is included so I wouldn't bill a debridement code at the same time unless its a different lesion than what is being drilled.
    Hope that makes sense.

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