AHA Coding Clinic® for HCPCS - 2025 Issue 2; Ask the Editor

Open matrix-induced autologous chondrocyte biopsy

A patient presents for a left knee medial patellofemoral ligament (MPFL) reconstruction with allograft, open autograft osteochondritis dissecans (OCD) fixation, and matrix-induced autologous chondrocyte implantation (MACI) biopsy. Standard inferior lateral and medial portals were created and the trocars inserted. The diagnostic arthroscopy was performed and a large OCD loose cartilaginous body was identified in the lateral compartment. A small area of chondromalacia was identified in the medial femoral condyle. No other abnormalities were identified and the intra-articular arthroscopic examination was complete.Since the OCD lesion was large, A 5 cm incision was made laterally to the patella, through the skin and subcutaneous tissue exposing the lesion. The loose piece was removed leaving a defect that was repaired with the loose piece and screw placement. The edges were trimmed and the piece was flush with the native cartilage. The MACI biopsy was obtained from a non-weight bearing area of the superior lateral trochlea. The retinaculum was closed and attention was turned to the MPFL reconstruction.According to the parenthetical note under CPT code 27412, code 29870 is assigned for the harvesting of chondrocytes. However, in this case, although the procedure began arthroscopically, the cartilage biopsy was ultimately performed via an open approach.How should the harvesting of knee cartilage be coded when performed through an open technique? ...

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