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29877 or 29879

  1. #1
    Location
    NEW ORLEANS
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    954
    Default 29877 or 29879
    Medical Coding Books
    Doc did a medial meniscectomy 29881 with a chondroplasty of trochlear groove. Operative report only stated that patient had grade 111 chondromalacia of the patella and grade 1V of the trochlea groove with multiple loose bodies flowing throughout the knee joint which was removed with a basket and shaver .thats all was said on the condroplasty. Would this still be ok to bill . booking was 29879 , but leaning towards 29877, but seemsto me info is lacking , any suggestions ? note- he did state about the meniscectomy but nothing nothing in that area was about the chondroplasty.

  2. #2
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    Please post a scrub version of the note.

  3. #3
    Location
    NEW ORLEANS
    Posts
    954
    Default ok
    POSTOPERATIVE DIAGNOSES: Right knee medial meniscus tear, grade IV chondromalacia trochlear groove, loose bodies, medial plica, and left ring finger mass.

    OPERATION: Arthroscopy right knee, partial medial meniscectomy, synovectomy with plica excision, chondroplasty of trochlear groove, removal of loose bodies, and removal of ganglion cyst left ring finger.

    ANESTHESIA: General.
    COMPLICATIONS: None.
    BLOOD LOSS: Minimal.
    PROCEDURE IN DETAIL:
    After obtaining a proper informed consent from the patient, he was taken to the operating room and given general anesthesia per endotracheal tube. Right knee and left hand were prepped and draped in the usual sterile fashion. The right knee was addressed first. Standard arthroscopy was performed through inferolateral and inferomedial portals. The patient had grade III chondromalacia of the patella and grade IV chondromalacia of the trochlea groove with multiple loose bodies flowing throughout the knee joint which we removed with basket and shaver. The patient had a small medial meniscus tear and a partial medial meniscectomy was performed. The patient had thickened medial plica and synovectomy with plica excision was performed. Lateral compartment was normal. ACL and PCL were intact. Knee joint was irrigated and injected with Marcaine and Duramorph. 4-0 nylon sutures were used on the skin. Left hand was then addressed and tourniquet was inflated for 15 minutes during the case. Transverse incision was made at the base of the ring finger over the mass. Care was taken to protect neurovascular structures. Mass was a ganglion cyst coming from the synovial sheath. The ganglion cyst was excised in its entirety. The tendon was intact. It was irrigated and injected with Marcaine. 4-0 nylon sutures were used on the skin.


    Sterile dressing was applied. The patient was taken to the recovery room in stable condition.

  4. #4
    Location
    NEW ORLEANS
    Posts
    954
    Default
    29877?

  5. #5
    Location
    Long Island/New York
    Posts
    1,271
    Default
    Quote Originally Posted by trent123 View Post
    POSTOPERATIVE DIAGNOSES: Right knee medial meniscus tear, grade IV chondromalacia trochlear groove, loose bodies, medial plica, and left ring finger mass.

    OPERATION: Arthroscopy right knee, partial medial meniscectomy, synovectomy with plica excision, chondroplasty of trochlear groove, removal of loose bodies, and removal of ganglion cyst left ring finger.

    ANESTHESIA: General.
    COMPLICATIONS: None.
    BLOOD LOSS: Minimal.
    PROCEDURE IN DETAIL:
    After obtaining a proper informed consent from the patient, he was taken to the operating room and given general anesthesia per endotracheal tube. Right knee and left hand were prepped and draped in the usual sterile fashion. The right knee was addressed first. Standard arthroscopy was performed through inferolateral and inferomedial portals. The patient had grade III chondromalacia of the patella and grade IV chondromalacia of the trochlea groove with multiple loose bodies flowing throughout the knee joint which we removed with basket and shaver. The patient had a small medial meniscus tear and a partial medial meniscectomy was performed. The patient had thickened medial plica and synovectomy with plica excision was performed. Lateral compartment was normal. ACL and PCL were intact. Knee joint was irrigated and injected with Marcaine and Duramorph. 4-0 nylon sutures were used on the skin. Left hand was then addressed and tourniquet was inflated for 15 minutes during the case. Transverse incision was made at the base of the ring finger over the mass. Care was taken to protect neurovascular structures. Mass was a ganglion cyst coming from the synovial sheath. The ganglion cyst was excised in its entirety. The tendon was intact. It was irrigated and injected with Marcaine. 4-0 nylon sutures were used on the skin.


    Sterile dressing was applied. The patient was taken to the recovery room in stable condition.
    i WOULD QUESTION YOUR DOC TO SEE IF HE PERFORMED A CHONDROPLASTY (29877) OF THE PATELLA. SINCE SYNOVECTOMY/PLICA EXCISION WAS DONE IN SAME COMPARTMENT AS 29881 YOU COULD NOT CAPTURE. ALSO BE SURE TO CAPTURE THE CYST EXCISION...29879 WOULD REQUIRE A DRILLING DOWN INTO BONE MARROW WHICH YOUR DOC DID NOT DO...

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