Orthopedic Coding Alert

Things get murky when you get to surgical knee fixes.

Patients who walk (or limp) into the orthopedist’s office with knee issues often leave after having a diagnostic or surgical knee arthroscopy and receiving a diagnosis from the provider.

The key to correct claim coding is knowing where to look in the ICD-10 and CPT^® manuals so you can quickly identify the necessary codes for the claim and move on to the next one.

We got Heidi Stout, BA, CPC, COSC, PCS, CCS-P, with Coder on Call, Inc., in Milltown, New Jersey, to give us a rundown of some of the most common diagnoses and CPT^® codes found on knee arthroscopy codes. It’s not a complete list, but there’s a lot of common ground that orthopedists tread when patients have knee arthroscopies. Keep this list handy to eliminate questions when coding these services.

ICD-10 codes

According to Stout, some of the more common injuries and conditions requiring knee arthroscopy include:

• S83.2- (Tear of meniscus, current injury)
• S83.5- (Sprain of cruciate ligament of knee)
• M17.1- (Unilateral primary osteoarthritis of knee)
• M22.- (Disorder of patella)
• M23.2- (Derangement of meniscus due to old tear or injury) through M23.8- (Other internal derangements of knee)
• M25.86- (Other specified joint disorders, knee)
• M93.2- (Osteochondritis dissecans)

Note: Be ready to dig in when you’re searching the M23.2- through M23.8- set; there are several dozen very specific codes to choose from in this relatively short ICD-10 range.

CPT^® codes

According to Stout, common arthroscopic procedures for the knee include:

• 29870 (Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)).
• 29880 (Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed) through 29883 (Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral))
• 29888 (Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction)
• 29875 (Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (separate procedure))
• 29877 (Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty))
• 29879 (Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture)
• 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (eg, osteochondritis dissecans fragmentation, chondral fragmentation))
• 29873 (Arthroscopy, knee, surgical; with lateral release)
• 29871 (Arthroscopy, knee, surgical; for infection, lavage and drainage)
• 29885 (Arthroscopy, knee, surgical; drilling for osteochondritis dissecans with bone grafting, with or without internal fixation (including debridement of base of lesion)).