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OCD lesion

Linda Posted Sun 28th of October, 2012 16:18:50 PM

What code would be used for debridement and drilling OCD lesion? It was not done arthroscopally so can not use the 29892. Doc thinks 28445 but is it truley a fracture?

SuperCoder Answered Mon 29th of October, 2012 13:09:48 PM

This scenario comes up frequently in arthroscopic surgery. There are two appropriate ways to submit the claim:

1. Code the arthroscopy (29892, arthroscopically aided repair of large osteochondritis dissecans lesion, talar dome fracture, or tibial plafond fracture, with or without internal fixation [includes arthroscopy]) with a -53 modifier (discontinued procedure), and the arthrotomy (28445, open treatment of talus fracture, with or without internal or external fixation) with a -59 modifier (distinct procedural service) and send both the operative note and letter explaining the circumstances; or

2. Do not code the arthroscopy, but append modifier -22 for unusual procedural services to 28445 and send both the operative note and clarifying letter. In a gray area like this, it is a good idea to call the carrier and see how it would recommend you code the procedures.

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