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Hello! Can someone please tell me what CPT to use for cell harvest of the knee. Would it still be CPT 29870? A thread in 2020 shows this is one of the codes but the description of CPT 29870 is Arthroscopy, knee, diagnostic, with or without synovial biopsy(separate procedure). Please see below for the op report.
Thank you.
POSTOPERATIVE DIAGNOSES: Right knee osteochondral fracture of patella with patella dislocation, complex tear in the midzone of the lateral meniscus, grade 4 chondromalacia of patella, and loose body.
With the patient in the supine position under adequate anesthesia, a tourniquet was placed high in the thigh, but was not used during the procedure. The right knee was prepped and draped in the usual sterile manner. An inferolateral anterior portal was established. Arthroscopic sheath was introduced. The arthroscope was introduced.
The camera was attached. Inflow and outflow was placed through the scope. Inspection began in the suprapatellar pouch, which was free of loose bodies and free of synovial changes. Inspection continued in the undersurface of the patella, which showed an obvious osteochondral fracture of the patella surface most medially. There was surrounding blood and debris. The trochlear groove seemed to be intact. An inferomedial anterior portal was established and ultimately enlarged. Probing of the medial meniscus showed to be intact. The medial femoral and medial tibial condyles were intact. Inspection continued to the intercondylar notch showed an intact anterior and posterior cruciate ligament. Inspection continued to the lateral joint line, which showed a small, but complex tear in the midzone. A basket was introduced. Resection of torn meniscus was performed back to stable fibers. The lateral femoral and lateral tibial condyles were seen to be intact. Inspection continued to the lateral gutter, which was free of loose bodies. Attention was then turned back to the patellofemoral joint. Using a probe, it was discovered that a small wafer-thin articular surface fragment was present and was removed at this time with a loose body grabber. The fragment itself had a split in its central portion. There was a mild amount of bone still remaining to one-half of the fragment. A chondroplasty was performed of the remaining area. There was already some fibrinous repair seen in the host base. The medial patellofemoral ligament area showed some redness and some bleeding in that area. Motion analysis showed properly tracking patella sitting in the trochlear groove without displacement nor tilt. There was no obvious articular surface damage at the patella to trochlear contact. This fragmented piece was off the medial edge. Attention was then turned to the intercondylar notch and cell harvest was begun using a ring curette using cartilaginous tissue from the intercondylar notch nonweightbearing area. The fragments were removed, placed in a sterile cup to be ultimately transfer to a transport medium to ultimately be transferred to the facility. Several liters of fluid had been run through the knee. The knee was drained dry. The instruments were removed. Then, 4-0 nylon interrupted sutures were used to close the wound and the medial wound was closed deeply with 4-0 Vicryl interrupted sutures as well as 4-0 nylon interrupted suture. Sterile dressing was applied. A Jones dressing was applied.
Question - Arthroscopic chondrocyte harvesting from knee
Code 29870 is listed as a "Separate Procedure" which means you can't bill with a procedure in the same area.
www.aapc.com
POSTOPERATIVE DIAGNOSES: Right knee osteochondral fracture of patella with patella dislocation, complex tear in the midzone of the lateral meniscus, grade 4 chondromalacia of patella, and loose body.
With the patient in the supine position under adequate anesthesia, a tourniquet was placed high in the thigh, but was not used during the procedure. The right knee was prepped and draped in the usual sterile manner. An inferolateral anterior portal was established. Arthroscopic sheath was introduced. The arthroscope was introduced.
The camera was attached. Inflow and outflow was placed through the scope. Inspection began in the suprapatellar pouch, which was free of loose bodies and free of synovial changes. Inspection continued in the undersurface of the patella, which showed an obvious osteochondral fracture of the patella surface most medially. There was surrounding blood and debris. The trochlear groove seemed to be intact. An inferomedial anterior portal was established and ultimately enlarged. Probing of the medial meniscus showed to be intact. The medial femoral and medial tibial condyles were intact. Inspection continued to the intercondylar notch showed an intact anterior and posterior cruciate ligament. Inspection continued to the lateral joint line, which showed a small, but complex tear in the midzone. A basket was introduced. Resection of torn meniscus was performed back to stable fibers. The lateral femoral and lateral tibial condyles were seen to be intact. Inspection continued to the lateral gutter, which was free of loose bodies. Attention was then turned back to the patellofemoral joint. Using a probe, it was discovered that a small wafer-thin articular surface fragment was present and was removed at this time with a loose body grabber. The fragment itself had a split in its central portion. There was a mild amount of bone still remaining to one-half of the fragment. A chondroplasty was performed of the remaining area. There was already some fibrinous repair seen in the host base. The medial patellofemoral ligament area showed some redness and some bleeding in that area. Motion analysis showed properly tracking patella sitting in the trochlear groove without displacement nor tilt. There was no obvious articular surface damage at the patella to trochlear contact. This fragmented piece was off the medial edge. Attention was then turned to the intercondylar notch and cell harvest was begun using a ring curette using cartilaginous tissue from the intercondylar notch nonweightbearing area. The fragments were removed, placed in a sterile cup to be ultimately transfer to a transport medium to ultimately be transferred to the facility. Several liters of fluid had been run through the knee. The knee was drained dry. The instruments were removed. Then, 4-0 nylon interrupted sutures were used to close the wound and the medial wound was closed deeply with 4-0 Vicryl interrupted sutures as well as 4-0 nylon interrupted suture. Sterile dressing was applied. A Jones dressing was applied.