Orthopedic Coding Alert

Question: What code would I use for a knee arthroscopy with OATS procedure? In the op note, the orthopedist states that he transplanted osteochondral auto- and allograft tissue to the medial femoral condyle. We used 29866, but the carrier denied payment for the procedure, stating that it was experimental. Georgia SubscriberAnswer: During an osteoarticular transfer system procedure, your orthopedist uses the arthroscope to treat focal cartilage defects by moving small pieces of undamaged cartilage within the joint to a damaged area of cartilage or implanting allograft plugs. He may use the patient's own cartilage (autograft) or that from a cadaver (allograft).When the surgeon uses an autograft, you should report the procedure with 29866 (Arthroscopy, knee, surgical; osteochondral autograft[s] [e.g., mosaicplasty] [includes harvesting of the autograft]). If he uses an allograft, however, you should rely on 29867 (... osteochondral allograft [e.g., mosaicplasty]). Consequently, you were correct when you reported your physician's [...]