Orthopedic Coding Alert

Question: The surgeon repaired a torn anterior cruciate ligament (ACL) and a torn medial meniscus on a Medicare patient. He also performed chondroplasty on the lateral femoral condyle. How do I code for all these procedures?

Louisiana Subscriber

Answer: For this, use code 29888 (Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction) for the ACL repair. For the medial meniscus repair, use 29882 (Arthroscopy, knee, surgical; with meniscus repair [medial OR lateral]) and append modifier 51 (Multiple procedures) to this code to indicate the added work. Last, for the lateral chondroplasty, use the code G0289 (Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage [chondroplasty] at the time of other surgical knee arthroscopy in a different compartment of the same knee).

These codes work for your patient because he is a Medicare patient. If he was a non-Medicare patient, your code would change. Instead of G0289, you would instead report 29877 (Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage [chondroplasty] at the time of other surgical knee arthroscopy in a different compartment of the same knee) and append modifier 59 (Distinct procedural service) since these codes cannot be bundled together.

These complex injuries are common in athletes so the torn ACL and injuries like it result in operations most frequently in the summer.