# Meniscus repair or debridement?



## SirCodesAlot07 (Jul 1, 2013)

I need help coding the following op report. The doctor wants to use 29882 and 29876.  I don't agree with 29882 since the meniscus was only debrided, I don't see where he really repaired it. Also, he dictated a tear in the medial and lateral menisci. So 29882 wouldn't be correct anyway, right?   Thank you in advance!


After informed consent was obtained, the patient was brought into the operative suite and placed in the supine position and given LMA.  The left knee was examined under anesthesia.  Range of motion was 0 to 140.  ACL, PCL, MCL, and LCL were intact.  Scope was introduced.  The left leg was then placed in a non-sterile tourniquet and was exsanguinated with an Esmarch and placed in arthroscopic leg holder and then prepped and draped in a regular sterile fashion.  The inferomedial and inferolateral arthroscopic portals were created.  I started the arthroscopy in a suprapatellar joint.  There were no loose bodies.  The scope was then introduced into the medial joint.  There was noted to be grade III and IV changes on the weightbearing portion of the medial femoral condyle and there was a tear in the posterior horn of the medial meniscus.  I used a shaver to debride this tear to a stable rim.  I then performed a medial synovectomy.  I put the scope into the notch.  The ACL and PCL were intact.  There was noted to be a 1 x 1 cm full-thickness chondral loss lesion of the trochlea and I debrided this with a shaver.  I performed chondroplasty of this chondral lesion.  I then placed the scope into the lateral compartment.  There was noted to be a tear in the lateral meniscus.  This was debrided with a shaver and arthroscopic biter to a stable rim.  The chondral surfaces were intact.  Then, I performed a lateral synovectomy as well.  I removed the arthroscopic equipment.  I closed the portals with 4-0 nylon.  I injected the portals with Marcaine, dressed with Xeroform, 4x4s, cast padding, and an Ace wrap.


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## jdemar (Jul 1, 2013)

29880; for medial & lateral meniscectomy, the chondroplasty and synovectomy are included because all chondroplastys are now included and the synovectomy is in the same compartment (lateral) as the meniscectomy.


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## scooter1 (Jul 1, 2013)

I agree with jdemar

just 29880


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## michelle052869@gmail (Jul 26, 2013)

I have a question:  If a provider performs a medial and lateral meniscectomy (29880) and performs a tri-compartment synovectomy (medial, lateral, patella) 29876.  How would you pay this?  Here is my thoughts:  If the medial and lateral synovectomy is considered inclusive to the medial and lateral meniscectomy and should not be paid.. that would leave the patella compartment only billable.  Would you then change the 29876 to a 29875.  However, doing that would then create the biller to deny CPT code: 29875 as a "Separate Procedure" code.  The provider would then only get paid for 29880.  Or, would the provider be able to append a 59 modifier to the 29875 to state he has done the extra work in the medial/lateral compartments but realizes he can't get paid for them, but should get paid for at least the patella compartment by down-coding to the 29875???  Thoughts anyone??


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## nyyankees (Jul 29, 2013)

michelle.reedy@libertymutual.com said:


> I have a question:  If a provider performs a medial and lateral meniscectomy (29880) and performs a tri-compartment synovectomy (medial, lateral, patella) 29876.  How would you pay this?  Here is my thoughts:  If the medial and lateral synovectomy is considered inclusive to the medial and lateral meniscectomy and should not be paid.. that would leave the patella compartment only billable.  Would you then change the 29876 to a 29875.  However, doing that would then create the biller to deny CPT code: 29875 as a "Separate Procedure" code.  The provider would then only get paid for 29880.  Or, would the provider be able to append a 59 modifier to the 29875 to state he has done the extra work in the medial/lateral compartments but realizes he can't get paid for them, but should get paid for at least the patella compartment by down-coding to the 29875???  Thoughts anyone??



You would append a 59 mod to 29875 to show separate knee compartment..


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