Reader Question: Keep Notchplasty and ACL/PCL Reconstruction Apart

Question: How would we separately bill for a notchplasty in the patellofemoral compartment to the anterior cruciate ligament (ACL)/posterior cruciate ligament (PCL) when the physician performs it in addition to lateral meniscectomy?

Oregon Subscriber

Answer: You shouldn't separately report a notchplasty when the physician performs an ACL or PCL reconstruction. Report code 29888 (Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction) for ACL reconstructions, and 29889 (Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction) for PCL reconstructions.

The ACL and PCL pass through a recess between the femoral condyles that looks like an upside-down "U." The "U" shape is called a notch. Some ACL-tear patients have a condition called notch stenosis in which the notch is too small for the ACL and PCL to pass through. In these cases, the physician performs notchplasty to enlarge the area and allow the ligaments to fit properly.