If you happen to experience swelling and well-localized pain in the knee, which is made worse by twisting or squatting motions, then it must be a symptom of a torn meniscus. A meniscus (also called menisci) is a C-shaped band of cartilage (between the femur and the tibia) in your knee that acts as a shock absorber or cushion between the knee’s bones and helps to move your knee joint correctly. There is one on the medial side (side closest to the midline of the body) and one on the lateral side of each knee. Generally, torn meniscus injury is most common among athletes or physically active individuals who get engaged in contact sports like hockey and football. People may also suffer injuries when they kneel, squat, or lift something heavy. In some cases, a torn meniscus may heal with conservative treatment modalities such as rest and reduced physical activity. However, in most cases long-lasting pain relief can be achieved through a surgical procedure known as a “meniscectomy”. Meniscectomy is an arthroscopic surgical procedure used to treat a torn meniscus cartilage in the knee. Orthopedic surgeons or other physicians who perform this surgical procedure need to correctly document the same in the patient’s medical records. Opting for billing and coding services from a reputable medical billing and coding outsourcing company can help simplify the documentation process.
According to recent reports, repair of a torn meniscus is regarded as one of the most common knee surgical procedures performed on people above 65 years. A tear in the meniscus can occur in one or more directions. Traumatic tears caused due to traumatic injury (common in athletes) are usually vertical whereas degenerative tears (visible in older patients who have more brittle cartilage) are usually horizontal. Degenerative tears are more common in people over 40 and may occur without a specific injury. Smokers are at higher risk for degenerative tears. The type of the tear (the location, length and pattern) may specifically determine whether a tear can be repaired or not. In addition, the condition of the knee, age of the patient, and injury-related degeneration will also be considered.
Types of Meniscectomy
There are two types of meniscectomy – partial and total meniscectomy. In partial procedure, the surgeon will remove only a part of the torn meniscus so that the knee can function normally. On the other hand, for total meniscectomy the surgeon will remove the whole meniscus. As with any surgical procedure, removing the torn meniscus carries its own set of risks and complications such as – chronic pain, blood clots, infections, nerve damage, bleeding and knee stiffness after performing the procedure.
How Is Meniscectomy Performed?
Generally, a meniscectomy is performed arthroscopically under general or local anesthetic. The surgeons will make small cuts or incisions in the knee, typically about 1 centimeter in long. Through these incisions, the surgeon can access the meniscus using special surgical tools and a tiny camera. This will help them analyze the extent of menisci damage and clean out the area, thereby repairing the tears. In addition, the surgeon may also fix other damage to bones, ligaments, tendons, or tissue during this surgery. The surgical wounds will be closed using stitches, staples or steristrips.
Orthopedics medical billing can be challenging as it involves using several code categories. Physicians and other orthopedic specialists who perform meniscectomy must use the relevant medical codes to bill for the procedure. The medical codes used to report meniscectomy include –
ICD-10 Codes
- S83.2 – Tear of meniscus, current injury
- S83.20 – Tear of unspecified meniscus, current injury
- S83.21 – Bucket-handle tear of medial meniscus, current injury
- S83.22 – Peripheral tear of medial meniscus, current injury
- S83.23 – Complex tear of medial meniscus, current injury
- S83.24 – Other tear of medial meniscus, current injury
- S83.25 – Bucket-handle tear of lateral meniscus, current injury
- S83.26 – Peripheral tear of lateral meniscus, current injury
- S83.27 – Complex tear of lateral meniscus, current injury
- S83.28 – Other tear of lateral meniscus, current injury
CPT Codes
- 27332 – Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee
- 27333 – Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee
- 29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
- 29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed
- 29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed
- 29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
- 29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
HCPCS Code
- G0428 – Collagen meniscus implant procedure for filling meniscal defects (e.g., CMI, collagen scaffold, Menaflex)
After the procedure, patients will be directly shifted to a recovery room wherein they will be closely monitored. In most cases, only minimal pain will be involved with this type of minimally invasive knee procedure. Patients will be given pain medications and antibiotics if they experience any kind of discomfort. Keeping the knee elevated will help reduce pain in the long run. In addition, icing the knee area will also be helpful.
After the initial monitoring, patients will be shifted to a separate room for full recovery. They will be given instructions to start small knee movements (after 2-3 days of surgery) to prevent blood clots. The patient’s legs may be put into a CPM (continuous passive motion) machine and the machine moves the leg back and forward slowly without straining. This will help reduce pain and help the knee heal faster. Patients will be given instructions to wear pressure stockings or inflatable boots after surgery. In addition, physiotherapists may recommend gentle stretching and strengthening exercises to reduce pain, swelling and improve range of motion. The time of recovery will vary depending on the injury, the type of surgical procedure performed, and the orthopedic surgeon’s preferences along with patient’s age, health status and activities. In most cases, patients who undergo arthroscopic meniscectomy can return to normal activities within 4 to 6 weeks.
Knowing the highly specific medical codes related to repairing a torn meniscus is critical for providers. Partnering with an experienced medical billing and coding company is a great option for physicians to ensure accurate and timely claim submissions.
Rajeev Rajagopal, the President of OSI, has a wealth of experience as a healthcare business consultant in the United States. He has a keen understanding of current medical billing and coding standards.