# Knee Scope with Open Hardware Removal



## Desperate Denise (Jan 1, 2010)

Here is a knee surgery I am having difficulty with - The payor is BS OF MASS.

Patient had an ORIF of a tibial plateau with plates and screws several years ago and has had knee pain refractory to nonoperative management.

The doc found through the arthroscopy - synovitis in the suprapatellar pouch, chondromalacia patellofemoral joint, lateral meniscus tear.  He also removed the plates and screws status post lateral tibial plateau ORIF.

These are the procedures listed:   ANY HELP WILL BE GREATLY APPRECIATED!!!

Arthroscopic partial synovectomy, chondroplasty of the patellofemoral joint and lateral compartment, partial lateral meniscectomy and then OPEN removal of plates and screws s/p lateral tibial plateau ORIF with bone grafting for the defects left from the screw removals.  He used Grafton and cancellous chips.

I would think I cannot bill for the partial synovectomy and chondroplasty of the lateral compartment for OA but I am confused about the modifiers and how to code the open hardware removal with bone grafting.  

Thanks for any help - HAPPY AND HEALTHY NEW YEAR!!!!


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## Bella Cullen (Jan 5, 2010)

Desperate Denise said:


> Here is a knee surgery I am having difficulty with - The payor is BS OF MASS.
> 
> Patient had an ORIF of a tibial plateau with plates and screws several years ago and has had knee pain refractory to nonoperative management.
> 
> ...



29881-79
20680-58
20900-58 for bone grafting.

I didnt check edits, but that is what i would code this as. 
Melissa, CPC


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## mbort (Jan 5, 2010)

ILuvRock said:


> 29881-79
> 20680-58
> 20900-58 for bone grafting.
> 
> ...



Since the injury was "many years ago" I would not use the 79/58 modifiers.  Those would only be needed if the patient were in the global period.


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## Desperate Denise (Jan 5, 2010)

*Arthroscopy with Hardware Removal*

Thanks guys - 

I have a question though - if the doc performed a chondroplasty in the patellofemoral joint and a partial lateral meniscectomy along with the hardware removal - would I be able to use G0289 for the chondroplasty in a different compartment?

Thanks again so much

Denise


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## nyyankees (Jan 6, 2010)

Desperate Denise said:


> Thanks guys -
> 
> I have a question though - if the doc performed a chondroplasty in the patellofemoral joint and a partial lateral meniscectomy along with the hardware removal - would I be able to use G0289 for the chondroplasty in a different compartment?
> 
> ...



I say yes.


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## Desperate Denise (Jan 6, 2010)

*Knee Scope and Hardware Removal*

Thanks everyone - I cannot tell you how much I appreciate your support!!

I am learning so much - 

Muche appreciated.

Denise


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