Orthopedic Coding Alert

Question: Should I be using code 0014T (Meniscal transplantation, medial or lateral, knee [any method]) located in Appendix B of CPT 2002? Does this code have to be used in combination with any other code(s)? Texas Subscriber Answer: Category III codes are considered "emerging technology codes," created by CPT to determine how frequently these new techniques are being employed. CPT states that if a Category III code is available, it should be reported instead of the Category I (five-digit) unlisted-procedure code. Medicare will recognize Category III codes in place of unlisted-procedure codes, but coverage and payment amounts are left to the discretion of the individual carriers.

There are two other Category III codes relevant to orthopedics, 0012T (Arthroscopy, knee, surgical, implantation of osteochondral graft[s] for treatment of articular surface defect; autografts) and 0013T ( allografts). Whenever possible, report Category III codes instead of an unlisted-procedure code for these procedures. But you should remember that not all insurance companies will accept Category III codes, so make sure your major payers are able to process claims with a Category III code before you submit.