Tanesha Posted Tue 26th of December, 2017 09:31:32 AM
What code would you use for the exostosis excision? 29999? He doesn't talk about removing the scope so I'm assuming the exostosis was removed by scope. Do you agree? What about the capsulectomy?
Procedure - 1. Excision of loose bodies from capsule, arthroscopic (CPT - 29834)
Procedure - 2. Lateral exostosis excision elbow
The skin incision was made in the previous scar tissue and extended down to the ridge along the junction between the triceps and anterior musculature of the distal humerus. We elevated this off the anterior portion keeping the collateral ligament intact. We entered the radial capitellar joint in the anterior 3rd. We performed a capsulectomy and removed all the abundant synovial tissue and used a standard arthroscope to evaluate the anterior capsule. We found 2 large loose bodies which was causing the locking and removed. We then found a lateral exostosis which we removed over the portion of the elbow and the region of the common extensor origin. We then close the capsule with inverted sutures. We then closed the interval for the muscle layer with a 3.0 suture. We then closed the skin with 4.0 Monocryl and the couter skin with 4.0 nylon suture.
SuperCoder Answered Wed 27th of December, 2017 04:29:12 AM
Use CPT code 29834 for elbow arthroscopy with with removal of loose body or foreign body.
Use CPT code 29838 for elbow arthroscopy with extensive surgical debridement.
Use CPT code 24120 for arthrotomy with excision of bone cyst or benign tumor from olecranon process.
Also, ensure that location of arthrotomy incision was different from that of arthroscopic procedure.
Hope this helps!
Tanesha Posted Wed 27th of December, 2017 08:11:31 AM
Thank you for your response. Where does the 29838 come from? The doctor also did a synovectomy. Wouldn't that be 29835 if partial?
SuperCoder Answered Thu 28th of December, 2017 07:34:32 AM
Cpt code 29838 will be used if in case there is 'removed all the abundant synovial tissue' as stated above, If performed partially, 29835 will be used.
Hope this helps!