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microfracture abrasion arthroplasty

  1. Cool microfracture abrasion arthroplasty
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    The surgeon did a microfracture abrasion arthroplasty of the MEDIAL femoral condyle,
    and then did a microfracture abrasion arthroplasty of the LATERAL femoral condyle.
    I know the CPT is 29879, but my question is do I code them separately? Or just once for the both of them? Would they be considered separate procedures? Please help, I have not come across this one before. . . . . Thanks

  2. Default Aaos 2005
    Abrasion arthroplasty

    "AAOS guidelines permit reporting of abrasion arthroplasty if the documentation supports that debridement was performed down to “bleeding bone.” Abrasion arthroplasty is not limited by compartments and can be reported twice if performed in both the medial and lateral compartments (as 29879 and 29879-59 or -51, depending on carrier issues).
    Many offices are reporting an abrasion arthroplasty (29879) when the documentation supports a chondroplasty (29877). Reporting a chondroplasty as an abrasion arthroplasty is considered “upcoding” and should not be done.

    According to the AAOS GSD, code 29879 covers: synovial resection for visualization; removal of osteochondral and/or chondral bodies (attached); diagnostic arthroscopy; chondroplasty; lavage and drainage; lysis of adhesions, and manipulation of the knee. It does not include arthroscopic meniscectomy and/or repair or arthroscopic removal of loose bodies or foreign bodies 5 mm or greater and/or through a separate incision.

    According to the August 2001 CPT Assistant, “When smoothing down the cartilage and/or drilling holes to create microfractures, code 29879 may be reported. Abrasion arthroplasty is usually performed to promote cartilage regeneration by creating access to blood and nutrients by smoothing down the cartilage and/or drilling holes to create microfractures. Code 29879 includes chondroplasty performed as part of the abrasion arthroplasty, so code 29877 should not be separately reported. If, however, chondroplasty is performed in a separate knee compartment, code 29877 may be reported separately. Modifier -59, Distinct Procedural Service, should be appended to indicate that a separate compartment was involved.”

    Margie Scalley Vaught, CPC, CCS-P, CPC-H, ACS-OR, is an independent coding specialist in Ellensburg, Wash., a BONES member and a past member of the National Advisory Board, American Academy of Professional Coders. She can be reached at"


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