# Medial Meniscectomy with Patellofemoral Debridement



## Robbin109 (Jan 29, 2014)

Can a patellofemoral debridement be billed with a medial meniscectomy, same knee?

Thank you


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## mcpalmeter (Jan 29, 2014)

Robbin,

Knee has three compartments:  lateral, medial, and patellofemoral.  Since the debridement was performed on a different compartment than the meniscectomy, the debridement can be billed separately.  You may need to append the 59 modifier to demonstrate that it is a different anatomical area.

- Maryann


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## OCD_coder (Jan 29, 2014)

I respectfully disagree as debridement, via a scope, is typically a synovectomy or a chondroplasty for the knee. Without knowing what you are debriding a modifier 59 is not supported to identify separate compartments for the 29881.  If you provided more information, I may be able to support a 29874-59.  

A synovectomy (29874/29875) and chrondoplasty  (29877) are both bundled codes and modifier's are *NOT* allowed with the 29881 when performed in the same knee.  The description for the 29877 as debridement/chondroplasty [Udescription specifically includes debridement of the same or different compartment.[/U]

Please clarify if a foreign body was removed?  Then the G0289 could be reported with a 29881. 

*CMS Medicare Rules:  NCCI Coding Manual, Chapter IV-6, IV-7*CPT codes 29874 (Surgical knee arthroscopy for removal of loose body or foreign body or foreign body) and 29877 (Surgical knee arthroscopy for debridement/shaving of articular cartilage) should not be reported with other knee arthroscopy codes (29866-29889). With two exceptions HCPCS code G0289 (Surgical knee arthroscopy for removal of loose body, foreign body, debridement/shaving of articular cartilage at the time of other surgical knee arthroscopy in a different compartment of the same knee) may be reported with other knee arthroscopy codes. Since CPT codes 29880 and 29881 (Surgical knee arthroscopy with meniscectomy including debridement/shaving of articular cartilage of same or separate compartment(s)) include *debridement/shaving of articular cartilage of any compartment*, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. HCPCS code G0289 should not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure.


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## smweiss (Jan 30, 2014)

*debridement/meniscectomy*

I agree with Maryann.  

You can bill them both as long as they are done in seperate compartments and you must append the modifier 59.


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## boyett (Aug 25, 2014)

i agree with the ocd_coder , if you read CMS Medicare Rules: NCCI Coding Manual, Chapter IV-6, IV-7 it specifically states you cannot use the g0289 nor the 29877 in conjunction with the 29880/29881 as it is included reguardless of the seperate compartment. The only way the g0289 is use in conjunction with the 29881/29880 is if you are reporting the loose body removal. all procedures will get paid if you bill them with the g0289 as long as the dont request records. otherwise they are assuming you are reporting the loose body removal. im sure they will take there money back if they decide to do an audit on those codes.


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## coderguy1939 (Aug 25, 2014)

If synovium is being derided that would fall under 29875 and it appears that NCCI, CPT & AAOS all now agree that code 29875 can only be coded if it is the only procedure being performed since it has a Separate Procedure designation.  If hard tissue is being derided it appears that it would fall under chondroplasty and the procedure descriptor in the CPT manual for both 29881 and 29880 states that debridement/shaving of articular cartilage (chondroplasty) in the same or separate compartment is included in menisectomy.  NCCI guidelines on the subject have already been covered by OCD coder and they are in agreement with CPT guidelines.

My opinion.


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