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Orthopedic Coding Alert

Reader Questions:

Include Notchplasty in ACL Reconstruction

Published on Tue Mar 18, 2008

Question: How should I code an arthroscopic notchplasty? The surgeon performed the procedure due to ACL graft impingement. Washington, D.C., Subscriber Answer: If the surgeon performs the notchplasty at the same time as an ACL reconstruction, you should not report the notchplasty separately. You should report only 29888 (Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction) for ACL reconstructions. If the surgeon only performs notchplasty, use an unlisted-procedure code, such as 29999 (Unlisted procedure, arthroscopy). Although some coders use 29877 (Arthroscopy, knee, surgical; debridement/shaving of articular cartilage [chondroplasty]), this code describes shaving articular cartilage rather than the bone removal of notchplasty, so you should stick with the unlisted-procedure code. The surgeon performs notchplasty to enlarge the U-shaped notch that the ACL and PCL pass through. The notchplasty allows the ligaments to fit properly.
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