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Congenital knee surgery

  1. #1
    Default Congenital knee surgery
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    How would y'all code this? I have a hard time seeing where the menisectomy was done, but I do see a chondroplasty! What about the band that was resected?


    PREOPERATIVE DIAGNOSIS: Discoid meniscus, right knee.

    POSTOPERATIVE DIAGNOSIS: Congenital malformation of right knee with fusion of anterior cruciate ligament, lateral meniscus, and lateral femoral condyle.

    NAME OF OPERATION: 1. Release of congenital fibrous band.
    2. Partial lateral meniscectomy.
    3. Chondroplasty of lateral femoral condyle.

    INDICATIONS: The patient is a 6-year-old male with history of a painful locking knee. He underwent x-rays which demonstrated a hypoplastic lateral femoral condyle. He underwent MRI scan which was consistent with discoid meniscus.

    REPORT OF OPERATION

    PROCEDURE: A two—portal diagnostic arthroscopy was performed as follows: His suprapatellar pouch showed no loose bodies. The chondral surface of his patella and femoral trochlea was normal. He had no loose bodies in either gutter. His medial joint space demonstrated normal medial femoral condyle and tibial plateau. He had a normal medial meniscus. His notch was examination demonstrated the anterior cruciate ligament to be relatively low-lying. This originated in the nine o'clock position. There was also a fibrous band that connected the lateral portion of the anterior cruciate ligament to the posterior horn of the lateral meniscus and the articular surface of the lateral femoral condyle. After resection of the band, the remaining lateral meniscus appeared healthy and not discoid. It was well attached at its periphery.

    A straight biter was placed and the band connecting the anterior cruciate ligament, meniscus, and articular surface was resected. A 3.5 mm shaver was then used to trim this further as well as smooth out the irregularity in the articular surface.

    After the chondroplasty had been performed, the knee was taken through live range of motion. There was no evidence of impingement of the anterior cruciate ligament. There was no further impingement on the articular surface by this band.

  2. #2
    Default Surgical Arthroscopy.
    Coding should be 29881-RT, 717.5.

    Others also share there thoughts.

  3. #3
    Default
    Thanks for the response, that's what I will go with, sounds good to me!

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