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Knee surgery advice

  1. Default Knee surgery advice
    Medical Coding Books
    Physician did partial medial and lateral menisectomies, debridement medial femoral condyle chodnro,medial plica excision and loose body removal.

    I know the procedure for the medial and lateral menisectomies is 29880 but in the op note he states "The patellofemoral jt was entered. There was a large plica involving the medial gutter region. using teh shaver and the arthrocare wand device, this was removed and hemostasis achieved with the arthrocare wand device. The medial part was then reentered and thoroughly irrigated.
    My question is whether i can bill for 29875 for removal of the medial plica. It was removed through the patellafemoral jt or if there is a medial plica is it considered inclusive of the medial menisectomy? Thanks for any help you can give me.
    Last edited by hlmcintyre; 02-25-2011 at 08:52 AM.

  2. Default Plica excision
    According to AAOS guidelines, plica excision/resection is inclusive when performed with meniscectomies. I came across that a lot when I first started coding and I learned through denials. Hope this helps.


  3. Default can bill for it if it is done because the plica is impinging and it is not done just for visualization purposes, i.e. the pt still would have had knee problems had the plica not been removed. I have been successful in receiving payment for this.

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