# Autograft/Allograft 29888



## AR2728 (Jun 14, 2011)

Are Autograft and Allograft both included in 29888 Arthroscopic ACL reconstruction?
Where can I find this information in writing if they are indeed included? My physician will want to know.  I have the coding companion, but it does not specifically state the information, (that I can locate anyway).  

Thanks much


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## nyyankees (Jun 14, 2011)

AR2728 said:


> Are Autograft and Allograft both included in 29888 Arthroscopic ACL reconstruction?
> Where can I find this information in writing if they are indeed included? My physician will want to know.  I have the coding companion, but it does not specifically state the information, (that I can locate anyway).
> 
> Thanks much



Only if an AUTOGRAFT is taken from a separate leg (highly unlikely). send your email I'll send an article for you and your doc.


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## JillSmithers (Sep 18, 2013)

nyyankees said:


> Only if an AUTOGRAFT is taken from a separate leg (highly unlikely). send your email I'll send an article for you and your doc.



Do you still have information on that article? I'm questioning it too. I'll send you my email if you can send me the article.


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## nyyankees (Sep 18, 2013)

JillSmithers said:


> Do you still have information on that article? I'm questioning it too. I'll send you my email if you can send me the article.



what is it?


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## scooter1 (Sep 18, 2013)

Mary LeGrand, RN, MA-CCS-P, CPC, a consultant with KarenZupko & Associates in Chicago, discusses the following three orthopedic coding challenges.
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1. Coding for arthroscopic reconstruction of anterior cruciate ligament (ACL) surgery. ACL surgery is defined by CPT 29888 (Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction). This CPT code is valued to include the harvesting and placement of a graft. 

Here are some key documentation issues to consider when reporting an ACL reconstruction.
1.	It is not uncommon in these cases to have an assistant surgeon or assistant at surgery, such as a PA. If the assistant will be reporting their services to the payor, the surgeon should document the name of the assistant, explain the medical necessity for having the assistant in on the case and describe the work the assistant performed. Typically the surgeon does this in preparation of the graft. 
2.	There are several tendons available for grafting. If the tendon is harvested from the same extremity, the harvest is included in the definition and payment for the ACL code 29888. If the tendon is harvested from the contraleral extremity and documentation of medical necessity is present, the surgeon may additionally report CPT code 20924 (Tendon graft, from a distance, such as palmaris, toe extensor, plantaris), appended with modifier -59. 
3.	There is no CPT code for the reconstitution of tendon allograft. The work associated with this is included in the payment for CPT 29888. 
4.	There is no CPT code for a revision ACL. If the surgeon performs a revision ACL and encounters significantly more work due to scar tissue, removal of grafts or hardware, the surgeon may consider appending modifier -22 to indicate the increased procedural service. Documentation of the additional physician's work must be very specific — significantly above and beyond the work associated with a primary ACL reconstruction.


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