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Orthopedic Coding Alert

Reader Question:

Don't Separately Bill ACL Graft Harvest

Published on Sat Oct 09, 2004

Question: In your August reader question "Include Graft Harvest in ACL Repair," you said that 29888 includes graft harvesting, so you should not report the harvest separately. But we harvest a bone graft from the lateral knee through a separate incision, so can we bill our graft harvest in addition to the ACL repair?

Maryland Subscriber Answer: No. According to the American Academy of Orthopaedic Surgeons' Complete Global Service Data Guide, reimbursement for the ACL repair (29888, Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction) includes the graft harvest. Therefore, you should not bill a graft harvest code with 29888.

Some surgeons reason that the ACL repair is arthroscopic and the graft harvest is an open procedure, so they are warranted in billing both procedures separately. However, 29888 describes an "arthroscopically aided" repair, not a strictly arthroscopic repair, which implies that aspects of the procedure are performed in an open fashion (chiefly the graft harvest).
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