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Open allograft dowel bone grafting of femoral and tibial tunnels

Angela Posted Wed 03rd of June, 2015 11:51:27 AM

Patient had a staged ACL revision and for the first stage the surgeon performed an open allograft dowel bone grafting of femoral and tibial tunnels. The surgeon would like to bill codes 27356 - Excision or curettage of bone cyst or benign tumor, tibia or fibula; with allograft and 27638 - Excision or curettage of bone cyst or benign tumor of femur; with allograft. Would that be an acceptable option instead of going with an unlisted code?

SuperCoder Answered Thu 04th of June, 2015 02:03:49 AM

The information provided seems inadequate. Request you to provide more information like procedures performed, indication and the diagnosis for which the procedure was performed. Post this information, I would be able to provide you with a appropriate CPT code.

Angela Posted Thu 04th of June, 2015 13:46:47 PM

Sure. The indication is a 33 year old male who is about 6 years out from an ACL reconstruction. He unfortunately has disrupted his reconstructed graft he also has a torn lateral meniscus. The diagnosis's are 1)Right knee disrupted anterior cruciate ligament status post anterior cruciate ligament reconstruction 2)lateral meniscus tear 3) cystic dilatation, tbial tunnel and femoral tunnel. Procedures performed are 1)Arthroscopic partial lateral meniscectomy 2)Hardware removal from proximal tibia and distal femur 3)Allograft dowel bone grafting of tibial tunnel and femoral tunnel.

SuperCoder Answered Fri 05th of June, 2015 02:45:48 AM

Please bill codes 29881 and 29867.

Code 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body) is a column 2 code for 29881 (Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral). These codes cannot be billed together in any circumstances. Code 29874 is bundled into code 29881 Code 29874 cannot be billed with 29881.

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