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Coding tip: Examine the new 2008 CPT code for osteochondral autograft knee procedures

Ambulatory Surgery Reimbursement Update, February 26, 2008

The American Medical Association has issued a new arthroscopic code for an open osteochondral autograft(s) of the knee for 2008. The code is 27416, for osteochondral autograft(s), knee, open (e.g., mosiacplasty) including harvesting of autograft(s). This is a very welcome addition, as physicians frequently perform this procedure in ASCs. The only code previously available for use for an open osteochondral autograft procedure of the knee was the unlisted code, which made reimbursement a challenge. While coders previously could report CPT code 29866 (Arthroscopy, knee, surgical; osteochondral autograft(s) [e.g., mosaicplasty] [includes harvesting of autograft(s)]) for this procedure when a physician performed it arthroscopically, there was no code for the open procedure.

Report code 27416 for the treatment of small to moderate size articular cartilage repair procedures. Report it only once on the claim form, regardless of the number of harvests or grafts the physician used in the repair. Do not report code 27416 with 27415 for the same case.

This tip is brought to you by Ellis Medical Consulting, Inc.

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