Orthopedic Coding Alert

Question: Our surgeon completed medial capsule reefing due to subluxation of the patella and performed microfracture of the lateral femoral condyle for osteochondritis dissecans (OCD). How should I code this?

Wisconsin Subscriber

Answer: File with 29879 (Arthroscopy, knee, surgical; abrasion arthroplasty [includes chondroplasty where necessary] or multiple drilling or microfracture). The American Academy of Orthopedic Surgeons (AAOS) advocates also reporting 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body [e.g., osteochondritis dissecans fragmentation, chondral fragmentation]) if the loose body is more than 5mm in size or requires a separate incision for removal. You cannot report 29879 and 29874 together, however, if they are in the same compartment.

Include 732.7 (Osteochondritis dissecans) as the claim diagnosis.