# CPT code for radiofrequency probe to tighten ACL



## Coder 646 (Jan 13, 2012)

Does anyone have an appropriate CPT code for this procedure other than the 29999?

Operative Discription given:

Diagnostic knee arthroscopy with arthroscopic lateral meniscal repair, debridement with removal of loose osteochondral fragment with partial chondroplasty of the lateral facet patella, tightening with radiofrequency probe of the ACL.

DX:

Lateral meniscus tear, complex type
Mild laxity of ACL
Chondromalacia lateral tibia patella, lateral femoral condyle
Flap-like osteochondral tear of subpatella


Procedure states:

"Diagnostic right knee arthroscopy did show an intact ACL.  There was some mild laxity to it. There was also some regrowth where we performed the notch plasty.  I did protect the ACL and then I was able to perform a more aggressive notch plasty and remove some of the impingement that was around the ACL from the lateral femoral condyle.  

I then lightly placed three Z-type strokes with the radiofrequency probe to tighten the ACL.  This was done under direct visualization. 

  The patient did have a flap-like tear at the lateral facet of the patella.  This is a loose cartilage tear that was trap door type . With the aggressive shaver and straight biter I was able to remove this loose fragment and perform a partial chondroplasty in this area.  Synovitis in the suprapatellar pouch is debrided.  

The patient had a very complex tear of the lateral meniscus.  There was a fish mouth portion as well as a red/white junction portion of the tear of the posterior horn of the lateral meniscus extending into the mid portion of the meniscus.  I was able to repair this with the use of the arthroscopic Smith and Nephew sutures.  I used five of these curved type sutures.  I secured and stabilized the fish mouth tear with two sutures and I repaired the red/white junctional tears with three sutures.  Following this, I was able to probe the meniscus and it was stable.  There was a small portion of the meniscus on the inner surface that I did debride and I removed because it was nonviable. I only removed about 5% of the meniscus

I choose ICD: 717.49, 718.86, 717.7, 717.89
I choose CPT: 29888, 29881

I am really stumped because I am not sure if these two CPT codes capture all the work done.  I am still pretty new to coding orthopedic surgeries, so any help will be grateful.

CJ


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## moodymom (Jan 16, 2012)

I would not code 29999 for thermal shrinkage. I have documentation from "orthopedic coder pro" stating that if *entire* procedure was done with thermal shrinkage then 29999 would coded. 

29888 is for acl reconstruction...that was not performed, so i would not use this cpt.

I would code 29882 for the lateral meniscus repair.
29877 or g0289 for chondroplasty and cartilage removal in the patella.
Per medicare 29877,g0289 is inclusive to 29882,however other carriers will pay for the procedure if done in different compartment.
Dx: 717.43, 717.49, 717.73, 717.83
i would also suggest  buying the ingenix coding companion....i love it and would hate to code w/o it.  Hope this helps


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## Coder 646 (Jan 19, 2012)

Thank you very much for the help.


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