# Arthroscopy knee w/lateral gutter



## fhysong (May 15, 2009)

Hi All,
Just looking for some help to educate my docs.  MD did Synovectomy, and Chondroplasty both in patellofemeral joint.  Then states removal of loose body in the lateral gutter, but he also did medial and lateral menisectomy.  I'm not allowing the synovectomy or the loose body but did allow the chondro due to higher RVU and different compartment.  Please let me know if this is correct?


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## mbort (May 15, 2009)

yes that would be correct.


(if it was hypotrophic synovitis, you could potentially capture that as well..just depends on the documentation and compartments)

Mary, CPC, COSC


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## faithvo (May 16, 2009)

Mary,

Could you elaborate a little more on billing for the synovectomy if due to "hypertrophic synovectomy"?  I have a doc who is notorious for performing a "tricompartmental synovectomy" for hypertrophic synovitis and this is almost always in addition to a meniscectomy(medial and/or lateral) and a patella chondroplasty.  

Any insight would be appreciated!  

Thanks!


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## coderguy1939 (May 16, 2009)

Without seeing the op report, I'd say you could bill for the lateral and medial menisectomy, chondroplasty of the patellofemoral compartment and if this isn't a Medicare patient or a carrier following CCI guidelines,  AAOS guidelines allow for capturing the loose body removal if it is not meniscal material from the menisectomy, is greater than 5mm or removed from a separate portal.  Mary, I've never seen any info on capturing the synovectomy for hypertrophic synovitis.  I'd love to see whatever you've got on that subject.


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