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Denial of 29877 or GO289

  1. #1
    Question Denial of 29877 or GO289
    Medical Coding Books
    I AM GETTING DENIALS FROM US DEPARTMENT OF LABOR WHEN BILLING 29877 (CHONDROPLASTY) WITH 29881 (MEDIAL MENISCECTOMY). IF I CHANGE TO G0289 (CHONDROPLASTY) STILL DENIAL..APPEAL LETTER SENT.. STILL DENIAL...

    OP-NOTE:
    POST OPERATIVE DIAGNOSIS:
    RIGHT KNEE MEDIAL MENISCUS TEAR, CHONDROMALACIA PATELLOFEMORAL JOINT AND SNYNOVIAL SHELF PLICA.

    PROCEDURE PERFORMED:
    RIGHT KNEE ARTHROSCOPIC PARTIAL MEDIAL MENISCECTOMY, ARTHROSCOPIC CHONDROPLASTY OF THE PATELLOFEMORAL JOINT AND EXCISON OF SYNOVIAL SHELF PLICA.

    DESCRIPTION:
    THE PATEIENT WAS TAKEN TO OPERATING ROOM AND PLACED SUPINE ON THE OPERATING TABLE. AFTER GENERAL ENDOTRACHEAL ANESTHESIA WAS ESTABILISHED, THE KNEE WAS TAKEN THROUGH RANGE OF MOTION. SHE HAD FULL RANGE OF MOTION. NO INSTABILITY. THE LEG WAS PLACED IN AN ARTHROSCOPIC LEG HOLDER. THE FOOT OF THE BED WAS DROPPED AND THE RIGHT KNEE AND LOWER EXTREMITY WERE PREPPED AND DRAPED IN STANDARD FASHION USING ALCHOL AND DURAPREP. STANDARD ANTEROLATERAL PORTAL WAS ESTABILISHED THROUGH A STAB INCISION. THE BLUNT WAS ENERED INTO THE INTERCONDYLAR NOTCH AND PUSHED INTO THE SUPRAPATELLAR POUCH ATRAUMATICALLY. AN ANTERIOR-SUPERIOR PORTAL WAS ESTABILISHED UNDER DIRECT VISUALIZATION AND THROUGH EXAMINATION OF THE KNEE ENSUED. THE SUPRAPATELLAR POUCH AND LATEROMEDIAL GUTTERS WERE FREE OF LOOSE BODIES OR SYNOVITIS. THE MEDIAL COMPARTMENT WAS ENTERED. THERE WAS A MACERATED TEAR OVER THE POSTERIOR HORN OF THE MID BODY OF THE MEDIAL MENISCUS. IT WAS DEBRIDED WITH A BASKET CUTTER AND SHAVER AND SAUCERIZED ANTERIORLY. THE PATELLOFEMORAL CARTILAGE SHOWED SIGNS OF GRADE 2 AND GRAD 3 CHANGES. CHONROPLASTY WAS COMPLED WITH AN ASCILLATING SHAVER. THE MEDIAL COMPARTMENT WAS COMPLETED. THE LATERAL COMPARTMENT WAS PRISTINE. THE ACL AND PCL WERE VISUALIZED. THEY WERE ALSO INTACT. THERE WAS NOTED TO BE A SYNOVIAL SHELF PLICA WHICH WAS EXCISED. AFTER THAT WAS DONE, THE KNEE WAS THOROUGHLY LAVAGED. 30 ML OF MARCAINE WAS INJECTED INTO THE JOINT AFTER REMOVING INSTRUMENTATION. THE INCISONS WERE CLOSED WITH 3-0 INTERRUPTED NYLON. THE INCISIONS WERE WASHED AND DRIED AND STERILE DRESSING APPLIED INCLUDING XEROFORM, 4X4, ABD, STERILE WEBRIL AND ACE WRAP FROM THE FOOT TO THE THIGH. THE PATIEINT TOLERATED THE PROCEDURE WELL, WAS EXTUBATED AND TAKEN TO THE RECOVERY ROOM.

    I CODED:
    836.0 (MEDIAL MENISCUS TEAR), 727.83 (PLICA) LINKED TO 29881 RT (MEDIAL MENISCECTOMY)
    717.7 (CHONDROMALACIA OF THE PATELLA) LINKED TO 29877 OR G0289 59RT (CHONDROPLASTY PATELLOFEMORAL)

    ***I BILLED BOTH WAYS ON THE CHONDROPLASTY...
    ****I HAVE APPEALED THIS W/DOCUMENTATION W/OP-NOTE, APPEAL LETTER, AND PAGES FROM THE AAOS COMPLETE GLOBAL SERVICE DATA BOOK

    I HAVE TWO DENIALS FROM KENTUCKY US DEPT OF LABOR..

    WHAT TO DO?????? ANY HELP GREATLY APPRECIATED...

  2. Default
    Just to clarify ~ it would be 29881 & 29877-59 or 29881 & G0289 (without modifier -59). So if you've done both of these and they're both denied, makes me wonder if it's more of a pre-authorization denial thing. We bill to USDOL and they are VERY strict about everything getting pre-auth'd. So maybe call them and see what the reason for your denials really is?...regardless of the reason they put on the EOB, since you've tried both ways. Good luck!
    Jenna

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