# Knee synovectomy, chondroplasy and removal of loose bodies



## SirCodesAlot07 (Feb 19, 2013)

I am trying to figure out how to code a knee surgery where the surgeon performed Knee synovectomy, chondroplasy and removal of loose bodies.  The physician coded it as
29876
29874-59

our current coder says it is 
29876
29877-59

I think due to NCCI edits they are both wrong but I am very new to this and don't want say anything unless I am truly correct. How would you code this op report?

Thank you in advance!

"With the patient under general anesthesia, the right lower extremity was prepped and draped in the usual sterile fashion and preoperative intravenous antibiotics were given.  The limb was exsanguinated with an Esmarch bandage and the tourniquet inflated prior to beginning of the procedure.  The superolateral portal was established for inflow, inferolateral portal for the arthroscope, and the inferomedial portal was used for probing, instrumentation.  Suprapatellar pouch as well as the medial and lateral compartments, and the intercondylar notch revealed synovitis.  With an arthroscopic shaver, synovectomy was performed in all three compartments.  This was not coincidental to the other procedures.  The patellofemoral joint revealed that there was degenerative arthritis mainly involving the patella.  There was loose articular cartilage and with arthroscopic shaver, chondroplasty of the patella was performed.  There were small cartilaginous loose bodies present throughout the knee, which were irrigated from the knee.  There were chondromalacic changes in the medial femoral condyle and medial tibial plateau, but the medial meniscus was well visualized and was intact to probing and visualization.  The lateral compartment revealed little degenerative change and normal lateral meniscus.  The intercondylar notch revealed intact anterior cruciate ligament.  After irrigating the knee, the wounds were sutured with 4-0 nylon suture.  A 20 cc of 0.25% Marcaine and 1 cc of Depo-Medrol were injected into the knee.  It was dressed with 4x4s and Ace bandage.  No complications.  She tolerated the procedure well."


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## PLAIDMAN (Feb 19, 2013)

*29876*

I would code the 29876 and nothing else.

the chondroplasty 29877 is included in 29876 and you cannot charge for loose body removal anymore UNLESS it is "non-meniscal" and in a separate compartment - Since he is saying he did synovectomy in all 3 compartments...that leaves you with no separate compartment.

I believe my thoughts are consistent with NCCI edits.

ANYONE ELSE??


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