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Orthopedic Coding Alert

Reader Question:

Distinguish Ganglion Cyst Excision from Spur Decompression

Question: Our surgeon did the following procedures:1. Right knee arthroscopic excision of superior patellar bone spur decompression. 2. Major debridement of ganglion cyst intraarticular parapatella superior, debridement of 25% quad tendon tear and excision of posterior patella cyst and scar. Would 29877 apply to this or do we report it as unlisted? Florida SubscriberAnswer: If your surgeon does an open procedure for cyst debridement, you report either 27340 (Excision, prepatellar bursa) or 27345 (Excision of synovial cyst of popliteal space [eg, Baker's cyst]). If however, your surgeon adopts the arthroscopic approach, you turn to option 29875 (Arthroscopy, knee, surgical; synovectomy, limited [eg, plica or shelf resection] [separate procedure]) as it appears that the synovectomy is limited to a single patellofemoral compartment in the knee. Code 29876 is bundled with 29877 (Arthroscopy, knee, surgical; debridement/shaving of articular cartilage [chondroplasty]). You will need documentation if you intend to bypass the edit.

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