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Thread: Arthroscopic debridment/lavage

  1. #1
    Join Date
    Apr 2007
    Biloxi, MS

    Default Arthroscopic debridment/lavage

    AAPC: Back to School
    HELP!! This seems like so much more to me than a 29871 is there also a debridement code I can use? I'm wondering if I looked at this too long. Any suggestions would be appreciated

    Septic right knee.
    Extensive irrigation and extensive debridement, right knee. Culture
    was obtained.

    Significant purulence and inflammatory tissue noted.

    Patient was placed on the operating room table in the supine
    position. Following successful anesthesia, a tourniquet was placed
    on the upper right thigh but not inflated. Right lower extremity
    was then prepped and draped in the usual sterile fashion. Patient's
    previous arthroscopy portals were utilized. An incision was taken
    sharply through skin and subcutaneous tissue. The scope was
    initially placed in the anterolateral portal but then alternated as
    necessary for visualization. The shaver was placed in the other of
    portal throughout the procedure. A significant amount of purulent
    fluid was initially encountered and drained. The irrigation was
    performed with 9 liters of normal saline fluid, and significant
    inflammatory synovitis was also encountered and debrided. A moderate
    degree of arthrosis, grade 2/3 degenerative changes was seen in all
    compartments. The medial and lateral menisci were intact. They
    were probed and they were not unstable. The ACL was significantly
    frayed and the most anterior and medial aspect was torn, this was
    debrided. The PCL was probed and was felt to be intact although not
    visualized. The gutters were noted to have synovitic tissue but no
    bodies were encountered. Following thorough irrigation a drain was
    placed inside the knee joint and brought out superolaterally, and the
    excess fluid was drained and all equipment were removed. The portals
    were reapproximated with 2- 0 nylon approximating skin and subcutaneous
    tissues. The dressings were applied which included, 4x4s, ABD pads,
    sterile Webril, and an Ace bandage to include the entire right lower
    extremity. The patient was then
    awakened, transferred to her bed and taken to recovery in
    satisfactory condition. Her procedures were free of complications.

  2. #2
    Join Date
    Apr 2007
    Bangor, Maine


    Probably too late to reply, but in MHO, I would just stick with the 29871, since it looks like a lot of the work was done in order to visualize where the real problem was.

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