Orthopedic Coding Alert

Question: My orthopedist performed the following knee procedure:

“Examination of the patient’s right knee with the scope showed the effusion to be serous and this was washed free. Patellofemoral tracking was good with chondromalacia, grade III and IV on the patellar side. Debridement was done for the chondrocalcinosis deposits in the medial compartment. The degenerative segments, basically grade V over a fairly large area in the medial femoral condyle, were debrided down with a chondrotome shaver. The medial meniscus showed tears in the anterior two-thirds, this was debrided with biters and shavers. In the notch, the ACL was found to be intact, although there were some chondrocal­cinosis deposits noted within the fibers, which also showed degenerative changes. The notch also was fairly stenotic. In the lateral compartment, chondrocalcinosis deposits were found. There was a tear of the anterior two-thirds of the lateral meniscus, again with deposits. In the posterior horn, there was a flap tear with heavy deposits. The deposits were removed with biters and shavers until a stable base from anterior to posterior was achieved.”

Can I report both the meniscal and articular shaving?

Texas Subscriber

Answer: Yes. The operative note describes debridement and shaving to remove the chondrocalcinosis deposits in the menisci and the articular cartilages of the right knee.

You should report 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; Right side)-RT.

For chondrocalcinosis, you report code M11.261 (Other chondrocalcinosis, right knee) and E83.50 (Unspecified disorder of calcium metabolism).