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bonedocs2

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I need help to code this surgery.
arthroscopic medial meniscus repair-29822
arthroscopic lateral meniscectomy - 29881
arthroscopic assisted tibial tunnel bone grafting and ACL graft - 27599

in the note he says there was a possibility of the need to stage an ACL reconstruction, and the possible need to bone graft the tunnels. He did the repair and the meniscectomy. He debrides the existing ACL. He does place bone dowels.
I just want to make sure I have the coding on this correct.
Any and all help with this is appreciated!
 

Is this case done yet or are you talking about getting prior auth? When you say, "in the note he says there was a possibility of the need to stage an ACL reconstruction, and the possible need to bone graft the tunnels." does that mean in the pre-op chart note or in the actual op note? Because your next sentence was, "He did the repair and the meniscectomy. He debrides the existing ACL. He does place bone dowels."
So it wouldn't be a possibility any longer if he did the case. Did the provider have to do anything with the femoral side?

See the link to a post about it above.

Also, old but can help: https://www.aapc.com/codes/coding-n...eport-staged-revisions-in-knee-111143-article
 
amyjph said:

Is this case done yet or are you talking about getting prior auth? When you say, "in the note he says there was a possibility of the need to stage an ACL reconstruction, and the possible need to bone graft the tunnels." does that mean in the pre-op chart note or in the actual op note? Because your next sentence was, "He did the repair and the meniscectomy. He debrides the existing ACL. He does place bone dowels."
So it wouldn't be a possibility any longer if he did the case. Did the provider have to do anything with the femoral side?

See the link to a post about it above.

Also, old but can help: https://www.aapc.com/codes/coding-n...eport-staged-revisions-in-knee-111143-article
Click to expand...
All of the above is in the op note. Here is the part for 27599
"Arthroscopic-assisted ACL debridement and tibial tunnel bone grafting: With the tunnel sites established, I was able to debride the existing ACL. We then assessed our femoral tunnel. It was in pretty good condition, pretty good position and although it looked like there was probably transtibial tunnel placement, so it was probably not as ideal, but the bone construct was in good condition and the socket was lightly debrided. We felt a femoral site was in good shape and then I turned my attention to the tibial side. There was a wallwing out of the tibial tunnel through most of the extent of the tunnel, so we went ahead and started at 8 mm reamer and now just reamed up sequentially up to about a 10 mm diameter and was able to get good bone exposure in the tunnel and was able to bring my camera down to the tunnel to evaluate this.
Once we had good bone exposure, I was able to then pass the 10 mm dilator in preparation for a 10 mm dowel. The dowel was inserted and impacted appropriately to allow for excellent placement of our bone dowel. It was a 31 mm x 10 mm diameter dowel. After this was done and we were satisfied with our dowel placement, we then removed the guidewire and then the excess fluid and fragments from the space. I then removed the instruments and then we closed the subdermal layer of the tibial tunnel wound with interrupted Vicryl and closed the skin with interrupted nylon."
 
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