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Skill Sharpener: Report This Arthroscopy

See if you can correctly code this knee procedure

Keeping in mind what you know about compartments and arthroscopy coding, test your skills by choosing the correct knee codes for this operative report.
Procedure: Arthroscopy of the right knee with a partial, medial and lateral meniscectomy, chondroplasty of a patellofemoral joint, and synovectomy in multiple compartments. 
Operative report: Physician carried out extensive synovectomy in the patellar, medial and lateral compartments using the curved tip power incisor. She then performed extensive chondroplastic shaving using the power shaver on the patella and femoral trochlea. She advanced the scope to the lateral joint, and performed chondroplastic shaving using the power shaver on the condyle. She then resected the meniscus back to a stable rim with basket forceps, taking about one-third of the body of the meniscus posteriorly.

She advanced the scope into the medial joint and  found a large tear of the posterior horn of the medial meniscus, which was entirely torn. She then resected it with basket forceps and a power shaver, taking about one-half of the body of the meniscus posteriorly. 
Solution: You know the synovectomy was performed in all three compartments - the medial, lateral, and patellofemoral - which should lead you to report 29876 (Arthroscopy, knee, surgical; synovectomy, major, two or more compartments). 
Because the physician states that she performed the meniscectomy in both the medial and the lateral compartments, you want to bill 29880 (... with meniscectomy [medial and lateral, including any meniscal shaving]) for those two compartments.
Finally, the doctor performed a chondroplasty in the patella, so you'll also report 29877 (... debridement/shaving of articular cartilage [chondroplasty]). Remember to append modifier -59 (Distinct procedural service) to this code.
Case and solution provided by Beth Fulton, CPC, CCS-P, CCP, a coding and auditing supervisor in Winston-Salem, N.C.

- Published on 2005-05-17