When your surgeon combines an open approach with an arthroscopic procedure, you’ll get full reimbursement only if you’re clear on reporting cases in which just part of the procedure is open approach. Read on for advice on correctly assigning seven key arthroscopic procedure codes that apply to arthroscopically aided procedures.
Confused Between 29855 and 29856? Condyles Count is the Key
Your surgeon may use arthroscope-assisted repair for the proximal tibial fracture in the tibial plateau that has a displacement and/or depression of the condylar surfaces. Specifically, tibial condylar fractures with ligamentous and meniscal injuries may require an arthroscopic-assisted elevation and screw fixation.
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Why: An arthroscopic approach causes less tissue damage than an open approach, aids to reduce depressed articular fractures, and allows for lavage in the joint. Arthroscopic approach also helps to remove hematoma, and allows concurrent work on ligamentous and meniscal injuries,” says Bill Mallon, MD, medical director, Triangle Orthopedic Associates, Durham, N.C.
Coding scenario: Let’s say you read in the operative note that your surgeon was treating a young patient with an unstable joint and a depressed fracture of the tibial plateau. You read further to confirm how the repair was done and to confirm if he used an arthroscopic approach. You read that your surgeon visualized the fracture in an arthroscope, made a window in the metaphysis, and elevated the depressed articular surface. You can further read that your surgeon used a graft for subarticular support and then used 1-2 cannulated screws...
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