Anesthesia Coding Alert
Consider Category III Code for OATS
Question: What are the correct codes for an osteochondral autograft transfer system (OATS) procedure for foot deformity? Pennsylvania Subscriber Answer: CPT includes only one code specific for OATS: Category III code 0012T (Arthroscopy, knee, surgical, implantation of osteochondral graft[s] for treatment of articular surface defect; autografts). According to CPT guidelines, physicians must report the appropriate Category III (temporary) code instead of a Category I unlisted-procedure code. However, this code does not fit your situation as well because the surgeon treated the patient's foot, not his knee. That means you should choose from the Category I codes even if they don't fully describe the procedure. If it had been a knee procedure, work from surgical code 29885 (Arthroscopy, knee, surgical; drilling for osteochondritis dissecans with bone grafting, with or without internal fixation [including debridement of base of lesion]). Codes 0012T and 29885 both cross to anesthesia code 01400 (Anesthesia for open or surgical arthroscopic procedures on knee joint; not otherwise specified). Be aware that many carriers such as Aetna and Unicare consider OATS to be an experimental procedure, which means they will not reimburse for it. Check with your carrier to determine their policy before reporting it.
When the physician performs OATS on the ankle or foot (as in your case), the only surgical coding option is 29999 (Unlisted procedure, arthroscopy). The Crosswalk includes several site-specific corresponding alternative codes for this, including 01464 (Anesthesia for arthro-scopic procedures of ankle and/or foot).
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