Orthopedic Coding Alert

Question: What percentage of the meniscus must the surgeon remove before we should bill the meniscectomy code instead of the chondroplasty code? Also, our orthopedic surgeon performed a medial meniscectomy with lateral and patellar chondroplasties on a Medicare patient. Which codes should we report?

California Subscriber

Answer: Let’s address your first question. The orthopedic surgeon does not need to document any particular percentage of meniscus removal to report the meniscectomy codes. The meniscectomy is a completely different procedure from chondroplasty. 

Op note hint: If the surgeon documents that he removed any portion of a meniscus with an arthroscopic shaver or arthroscopic scissors or punch, he performed a meniscectomy (29880-29881). If he documents that he trimmed or smoothed articular cartilage with the arthroscopic shaver, he performed a chondroplasty. Even though the meniscus is considered “fibrocartilage,” it is not the same type of cartilage as articular cartilage that is present at the end of bones. Anytime the physician removes meniscal tissue, you should consider it a meniscectomy.

As for your second question, you should not report a chondroplasty code. The National Correct Coding Initiative (CCI) bundles meniscectomies and chondroplasties. In this scenario, you should report the meniscectomy code only.