3 Tips for Coding Orthopedics Procedures in Surgery Centers

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Coding meniscectomies and synovectomy during left knee arthroscopy

During left knee arthroscopy surgery, the surgeon performs both a medial and lateral meniscectomy along with an extensive synovectomy, including the patellofemoral compartment. The coding would be reported as '29880-LT' for the meniscectomies and '29875-59, LT' for the synovectomy performed in the patellofemoral compartment.

The synovectomies for the medial and lateral compartments bundle with the meniscectomies since the procedures are performed in the same compartments. The limited synovectomy performed in the patellofemoral compartment is reported with the 59 modifier since it is performed in a separate compartment.

Coding biceps tenotomy during shoulder arthroscopy
Many times during arthroscopic shoulder surgery, a biceps tenotomy is performed along with other procedures. The biceps tenotomy is reported with CPT code 29999. The AMA has not assigned a specific CPT code for this procedure.

Coding platelet-rich plasma injections
Surgeons have been performing platelet-rich plasma injections during surgeries to promote healing of the musculoskeletal tissue. An example of this procedure is when, intraoperatively, a patient has blood withdrawn, the blood is centrifuged for 15 minutes to separate the platelet-rich plasma from the platelet-poor plasma and red cells and injected into a surgical site.

The placement/injection of the cells into the operative site is an inclusive component of the operative procedure performed and not separately reported.

CPT code 86999, unlisted transfusion medicine procedure, is used to report obtaining the cells for injection. However, as of July 1, 2010, CPT code 0232T has been assigned for this procedure.

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