# osteochondral defect mpj



## coder067 (Dec 15, 2011)

Arthroplasty with excision osteochondral defect and damaged cartilage. What code do you use for this procedure? I can't find anything related to this.

Thanks for your help!!


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## ajs (Dec 15, 2011)

TGIGLIO said:


> Arthroplasty with excision osteochondral defect and damaged cartilage. What code do you use for this procedure? I can't find anything related to this.
> 
> Thanks for your help!!



Need more info, can you post the op report?


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## coder067 (Dec 15, 2011)

At this time, an incision was made over the second toe encompassing the second MPJ.  We obtained deep, sharp, and blunt dissection down to the level of the deep fascia.  The incision was made down to the bone on the medial aspect of the extensor tendon and the second MPJ was opened up.  Immediately dorsal two-thirds of the cartilage was absent on the head of the second metatarsal.  There was also some loose cartilage medial and lateral to this.  There was also the dorsal one-third of the base and damaged cartilage as well.  At this time utilizing a combination of curette and rongeur, I removed the damaged cartilage on adjacent parts of the joint and then utilized a 0.045 K-wire to drill the bone to stimulate fibrocartilage formation.  Range of motion showed no crepitus and there was no loose cartilage at this time.


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## ajs (Dec 15, 2011)

TGIGLIO said:


> At this time, an incision was made over the second toe encompassing the second MPJ.  We obtained deep, sharp, and blunt dissection down to the level of the deep fascia.  The incision was made down to the bone on the medial aspect of the extensor tendon and the second MPJ was opened up.  Immediately dorsal two-thirds of the cartilage was absent on the head of the second metatarsal.  There was also some loose cartilage medial and lateral to this.  There was also the dorsal one-third of the base and damaged cartilage as well.  At this time utilizing a combination of curette and rongeur, I removed the damaged cartilage on adjacent parts of the joint and then utilized a 0.045 K-wire to drill the bone to stimulate fibrocartilage formation.  Range of motion showed no crepitus and there was no loose cartilage at this time.



After reading a lot of info in Encoder Pro I finally came up with 28022.  Seems to match the documentation!


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## coder067 (Dec 15, 2011)

Thank you so much for your help! That does sound like the correct answer. I was stumped.


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