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Coding tip: Use synovectomy codes for plica syndrome

Ambulatory Surgery Reimbursement Update, June 26, 2007

Plica Syndrome is a condition involving extra folds of material which normally help reduce friction within the knee or other joint but become abnormal.

This most commonly occurs along the medial (inside) of the knee. When the plica (bands of synovial tissue) becomes irritated, it can result in pain and inflammation.

Plica syndrome refers to symptomatic plica, which is coded with ICD-9 diagnosis code 727.83. The doctor may recommend arthroscopic or open surgery to remove the plicae if conservative measures do not resolve the problem.

CPT code 29875 (Arthroscopy, knee, surgical; synovectomy, limited (e.g., plica or shelf resection), which is designated as a "separate procedure" in the CPT book, or CPT code 29876 (Arthroscopy, knee, surgical; synovectomy, major, two or more compartments) are the codes you should use to bill for the resection of plica procedure.

Make sure to check the CCI edits if you are performing other knee procedures at the same operative session.

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

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