Orthopedic Coding Alert

Question: The orthopedist completed a three-compartment major synovectomy, medial and lateral meniscectomy, and PF chondroplasty. How do I code the encounter?

Wyoming Subscriber

Answer: Selecting codes for the meniscectomy and chondroplasty is simple: Report 29880 (Arthroscopy, knee, surgical; with meniscectomy [medial and lateral, including any meniscal shaving]) and 29877 (... debridement/shaving of articular cartilage).

Reporting the synovectomy gets trickier. CPT has two code choices for synovectomy: 29875 (... synovectomy, limited [e.g., plica or shelf resection] [separate procedure]) for one compartment and 29876 (... synovectomy, major, two or more compartments [e.g., medial or lateral]) for two or more compartments. Because physicians often perform synovectomy in conjunction with other procedures, always check the other codes and their scope before tallying your synovectomy compartments.

Example: Your surgeon completes a medial meniscectomy (29881, ... with meniscectomy [medial or lateral, including any meniscal shaving]) along with medial and lateral synovectomies. Although this is technically a two-compartment synovectomy, the medial synovectomy is included in the code for the medial meniscectomy. Therefore, you can report only a single compartment synovectomy (29875).

-- Reader Questions and You Be the Coder were reviewed by Heidi Stout, CPC, CCS-P, director of orthopedic coding services at The Coding Network LLC; and Bill Mallon, MD, orthopedic surgeon and medical director at Triangle Orthopaedic Associates in Durham, N.C.