Current literature suggests that at early-term to midterm follow-up, patients experience improved function, alleviation of pain, and good satisfaction with acceptable complication rates. Procedure Code: Arthroscopic [not open] Repair of Osteochondral Defects Looking at CPT 29885 through 29887 Thanks to one and all. Osteochondral allografts are typically used for larger Severe locking or catching symptoms, where the ankle freezes up and will not bend, may indicate that there is a large osteochondral lesion or even a loose piece of cartilage or free bone within the joint. 28446 29892 The use of CPT 29892 for arthroscopic osteochondral talus graft is per CPT instruction and is regardless of whether using an allograft or autograft; however, CPT codes 27899 or 28899 may also be seen. Coding: The following codes are included below for informational purposes only, and are subject to change without notice. Osteochondral lesions of the talus: are there any differences between osteochondral and chondral types? Am J Sports Med. [1] Historically, micro-fracture surgery has been utilized for smaller defects. Osteochondral Allograft Transfer (i. 3 (52 to 90) in the Karlsson-Peterson Ankle Score, at a mean follow-up of 36 months (24 to 83). 2013 Mar;41(3):504-10. Code +20933 describes partial (hemicylindrical) bone allograft, while +20934 describes complete (cylindrical) allograft. Mar 13, 2020 · Osteochondral allograft, autologous osteochondral graft, particulated juvenile cartilage transplantation, and autologous chondrocyte implantation have all been described. It is important to accurately report the procedure performed to ensure proper reimbursement. ) 28420 Open treatment of calcaneal fracture, includes internal fixation, when performed; with primary iliac or other autogenous bone graft (includes obtaining graft) 28445 Open treatment of talus fracture, includes internal fixation, when performed Other instability, ankle: Osteochondral allograft of talus: CPT codes not covered for indications listed in the CPB: 20962: Bone graft with microvascular anastomosis; other than fibula, iliac crest, or metatarsal: 28103: Excision or currettage of bone cyst or benign tumor, talus or calcaneus; with allograft: Other CPT codes related to the CPB Osteochondral grafts are used in repair of full thickness chondral defects involving a joint. Like an autograft, an allograft is a graft composed of cartilage and bone. Modifiers, such as -22 (increased procedural services), may be useful when there is a significant increase in the time, complexity and/or resources required for a procedure Osteochondral Allograft Convenience Kit provides surgeons with an option for addressing osteochondral defects of various geometries and sizes. Ankle, surgical excision of osteochondral defect of talus and/or tibia 28446 Open osteochondral allograft To order Arthrex instrumentation, please call Arthrex, Inc. Open osteochondral allograft transplantation/fixation (27416). , mosaicplasty) (includes harvesting of autograft[s])) could be considered for comparison. I have done some reading, and all I come up with are codes when it pertains to spinal procedures. Ankle sprains are a common cause of OLTs. 6% of all osteochondral ankle injuries. - Osteochondral Autograft Transplantation Limitations - Lesion size = Limited “extra” cartilage - Only Carticel can fill irregular shaped ACGME Case Log System for Foot and Ankle Orthopaedic Surgery has been revised to identify the CPT codes tracked to each defined case category. Comparison of chondral versus osteochondral lesions of the talus after arthroscopic microfracture. What would you use for a CPT code? I have searched for hours Unlisted Procedure Codes - Frequently Asked Questions Chondrofix® Osteochondral Allograft Coding Reference Guide. The surgeon did OTIF of the proximal humerous with tuberosities with bone graft. Inclusion or exclusion of a code does not constitute or imply member coverage or provider reimbursement. In the case of osteochondral autografts, one or more small osteochondral plugs are harvested from non-weight-bearing sites usually from the knee and press fit into a prepared site in the lesion. What code should we use for the excision, curettage, and drilling of osteochondral defect in the talus (i. We present an arthroscopically assisted technique that uses an allogenic cartilage graft in treating an osteochondral lesion of the medial dome of the talus. Feb 25, 2014 · lesions using multiple dowel grafts to secure the fragment. A type 1 lesion is located at the anterior part of the talar head. The description that the physician gave me is :Ankle Arthrotomy with debridement of talar osteochondral defect followed by bone marrow stimulation and application of BioCartilage. 70 N/A 5114 - Level 4 (MSK) Procedures CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; Autologous chondrocyte implantation: CPT codes covered if selection criteria are met: 27412: Autologous chondrocyte implantation, knee: 29870: Arthroscopy, knee, diagnostic; with or without synovial biopsy (separate procedure) Other CPT codes related to the CPB: 27416 Arthrex Coding Hotline 1-844-604-6359 . This code should not be reported with CPT codes 27705 or 27707. 133 summarized their results achieved from 12 patients with a minimum follow-up of 2 years. A malleolar osteotomy for exposure was needed in 26 patients and there were no malleolar mal- or non-unions. Oct 14, 2012 · You report this with code 28446 (Open osteochondral autograft, talus [includes obtaining graft(s)]). We take the healthy cartilage from an area of the bone that is non-weight bearing. For example, there is a separate code for a right, a left or a bilateral procedure. , 2017. Kane, M. Mar 18, 2021 · Typical ICD-10 Codes. , Chondrofix® Osteochondral Allograft [Zimmer Biomet, Warsaw, IN]) Ligament/Meniscus Reconstruction . Left ankle derangement. Osteochondral fracture fixation is traditionally performed in the acute setting with internal fixation procedures using pins or compression screws through the fragment. POSTOPERATIVE DIAGNOSIS: Osteochondral fracture anterolateral right talus. The CPT codes available in each category are listed; note that fellows are NOT expected to report cases using all listed CPT codes. Jun 2, 2016 · It was probably done Arthroscopically, so I would use an Arthroscopic Procedural Code. The patient's remaining ankle cartilage appeared to be grossly normal on inspection with only some mild degenerative grade 1 articular cartilage changes to the remainder of the patient's ankle joint other than the osteochondral lesion. The location of the osteochondral lesion allows one to infer the producing mechanism. Denovo NT Natural Tissue Graft Coding Reference Guide Aug 19, 2023 · Larger defects may require a bulk graft which can be a fresh frozen graft OATS, a packaged allograft Osteochondral Allograft Transfer (OATS), or an autograft OATS . Thanks Jul 9, 2014 · Need some help here, provider is asking if there is a CPT code to reflect the work needed to prepare the allograft to fill a sizeable defect left after ORIF of a pilon fracture. knee). Indications for retrograde drilling are still few and are far from clear, and some evolutions of the technique have recently occurred. Arthrex has a long standing partnership with leading tissue banks to provide fresh osteochondral allografts (OCA) for use in joint restoration procedures. Osteochondral Allograft Transplantation. PROCEDURE PERFORMED: Arthroscopy followed by open osteochondral transplant using an allograft and a medial malleolar osteotomy. and Crawford, D. 77 29870 Arthroscopy, knee, diagnostic, with or without synovial biopsy $417. Up to 75% of OLTs are caused by trauma, such as an ankle sprain or fracture. . Of the 50 patients, 45 (90%) had a mean good-to-excellent score of 80. Aug 20, 2010 · When synthetic plugs are used for osteochondral grafting of the knee (i. The same, however, does not apply for the ankle. , anterior cruciate ligament allograft) materials are considered medically necessary when medical necessity has been met for the associated primary procedure*. It is paramount that an evidence-based Osteochondral Allograft Transplantation - Allograft Transplantation is proving to be beneficial for large osteochondral defects where duplication of the anatomy would be difficult with autologous tissue. 87 $9585. Apr 29, 2014 · Need help with CPT code for this procedure: Open Repair of Osteochondral Defect Outpatient DX from MRI: Large, 2. The osteochondral defect is identified and marked. I'm thinking this is unlisted, 28899, and compare to 28446. Aug 20, 2021 · 1. , mosaicplasty), 29867 Arthroscopy, knee, surgical; osteochondral allograft (eg, mosaicplasty) may be assigned, even though the descriptor refers to allograft, per the December 2008 CPT® Assistant. 1 ProChondrix CR can be used in a variety of orthopedic reconstructive procedures to aid in the repair of articular cartilage. The following HCPCS codes are associated with Cartiform® Viable Osteochondral Allograft: There are no HCPCS codes specifically assigned to identify Cartiform viable osteochondral allograft. With osteochondral autografting, It is the provider’s responsibility to determine the appropriate codes and modifiers to be submitted. Physician CPT® Code Description Knee 27415 Osteochondral allograft, knee, open 29867 Arthroscopy, knee, surgical; osteochondral allograft (eg, mosaicplasty) Ankle This article reviews the etiology, clinical presentation, classification schemes, and treatment options for osteochondral lesions of the talus. Note that the definition of 27416 states “includes Feb 15, 2021 · Osteochondral Allografts. For questions on reimbursement or to find information for a specific product, please contact the Arthrex Coding and Reimbursement Hotline at 1-844-604-6359 or 27415 Osteochondral allograft, knee open $1378. Q: What CPT code do you suggest for Complete Plantar Plate Repair (CPR)? A: CPT codes 28285, 28308, 28270 or 28899 (unlisted) may be appropriate for documenting this repair. Dec 5, 2008 · POSTOPERATIVE DIAGNOSIS: Painful osteochondral lesion, medial talar dome, left ankle. I'm also looking at 27524. This prevents the need from harvesting bone and cartilage from another part of the body (ex. Then we match the graft to the surface area of the defect, leaving a smooth surface in the joint. Advances in storage techniques have demonstrated improved chondrocyte viability at longer intervals and allowed for potential of increased graft availability. Transplantation of viable, mature hyaline cartilage into the affected area is … DeNovo NT Natural Tissue Graft Coding Information Codes below are coverable when the preauthorization criteria are met: 27412 Autologous chondrocyte implantation, knee 27415 Osteochondral allograft, knee, open 27416 Osteochondral autograft(s), knee, open (eg, mosaicplasty) (includes harvesting of autograft(s)) osteochondral graft taken from the ipsilateral knee. 02% and 1. Surgical debridement and microfracture are indicated for symptomatic type 1 lesions if conservative treatment fails to relieve the pain. For such cases, the use of osteochondral allograft (OCA) transplant has been suggested. ↑ Park HW, Lee KB. Arthrex has the Allograft OATS Workstation to provide more flexibility in preparing the OCA in the Jun 11, 2019 · The Osteochondral Autograft Transfer System (OATS; Arthrex, Naples, FL) is an excellent option for the treatment of articular cartilage lesions within the knee. The preferred type of allograft for the ankle is fresh, non-frozen. Osteochondral allografts are typically used for larger lesions. , mosaicplasty) (includes Osteochondral Allograft Transplantation. Oct 17, 2008 · How do I code an allograft used in a shoulder surgery? The cpt codes I looked at are for spine surgeries. Rehabilitation and Postoperative Management Practices After Osteochondral Allograft Transplants to the Distal Femur: A Report From the Metrics of Osteochondral Allografts (MOCA) Study Group 2016 Survey. , Lau, K. Fracture amenable to arthroscopic approach 36 37 CPT Codes and Descriptions CPT Code CPT Code Description Osteochondral lesions of the talus (OLTs) are ankle joint injuries involving damage to the joint surface (cartilage) and/or underlying ankle bone (talus). 12 29867 Arthroscopy, knee, surgical; osteochondral allograft (eg, mosaicplasty) $1285. The defect is at the lateral talar dome. at 1-800-933-7001. While maintaining an intact cartilage structure, the bony portion of Cartiform viable osteochondral allograft is reduced and the graft is porated to offer unique handling characteristics and simple fixation techniques. 8 cm loose/displaced osteochondral fragment along peripheral anterolateral femoral condyle, donated from lateral femoral trochlea where there is a large osteochondral defect and bone marrow edema. Cartilage viability is one of the most important factors for successful clinical outcomes after transplantation of osteochondral allografts and is related to storage length and intra-operative factors. We describe in detail patient positioning, ankle distraction, portal placement, steps of the diagnostic arthroscopy, and the technique of Fresh osteochondral allograft (OCA) transplantation has been used to manage a wide spectrum of chondral and osteochondral knee disorders. To avoid prolonged surgical wait Jan 9, 2021 · A longer follow-up was presented in 2001 by Gross et al. Osteochondral Allograft Cpt Code Jay R. Mar 12, 2018 · Treatment options for the management of osteochondritis dissecans (OCD) lesions of the femoral head are limited. Although arthroscopic surgery of the hip can treat a variety of intra- and extra-articular pathologies, an OCD lesion located at the superior and medial zone of the femoral head is often difficult to access and cannot be adequately treated arthroscopically. *Note: Jan 11, 2019 · Applicable Procedure Codes 27415 Osteochondral allograft, knee, open 27416 Osteochondral autograft(s), knee, open (eg, mosaicplasty) (includes harvesting of autograft[s]) 28446 Open osteochondral autograft, talus (includes obtaining graft[s]) Oct 21, 2021 · Insurance Coding ICD-10 codes are much more specific than previous coding systems. (A) A straight osteotome is used to remove areas of damaged and unstable cartilage to the lateral femoral condyle. 23410 . A normal, healthy ankle joint is made up of smooth cartilage supported by strong bone underneath. 130 on fresh osteochondral allografts for repair of talar osteochondral lesions in 9 patients with a mean graft survival of 11 years (4-19 years. There is no category I CPT code for either procedure. Osteochondral allograft transplantation has been performed for the past 50 or more years with several studies demonstrating satisfactory outcomes. Code 24999 (Unlisted procedure, humerus or elbow) would be used for an open technique. Read the "AMA CPT Knowledge Base" question/answer titled: "What is the appropriate code to report for open osteochondral allograft of the ankle?"; - Subscription required Jun 23, 2009 · I need help with coding an ankle microfracture. Fresh allografts may be difficult to obtain and creates Mar 23, 2021 · Hello everyone, I'm trying to figure out how to code the fixation of an osteochondral defect. Coding. Lieberman, MD,Daniel J. Jul 23, 2019 · Advances have been made in the treatment for osteochondral defects of the talus, but these injuries continue to be a challenge for foot and ankle surgeons. The ATFL remnant is carefully dissected only at the footprint of the superior limb of the ATFL, and a bone tunnel is created on each side of the fibula and Oct 21, 2021 · CPT Codes 27415 – Osteochondral allograft, knee, open 27599 – Unlisted procedure, femur or knee 29867 – Arthroscopy, knee, surgical; osteochondral allograft 29999 – Unlisted procedure, arthroscopy Typical HCPCS Codes C1762 – Billing code for allograft Typical Revenue Codes (for form UB-04) 278 – Other implants CPT Modifiers May 20, 2008 · CPT 2008 brought you 27416, an all-new mosaicplasty code. (2) The graft is harvested while submerged in saline to limit thermal necrosis. Medicare requires that facilities submit a device Purpose: The aim of this systematic review is to report about the clinical use of partial and total fresh osteochondral allograft in the ankle joint. Allograft: 28899: Elbow Autograft: 24999 29999 For osteochondral graft of the elbow, the same unlisted code 29 Osteochondral lesions 30 Bursectomy 31 Evaluation of chronic unexplained pain and negative findings on 32 imaging (e. Any thoughts on Aug 19, 2011 · I need help coding this--I cannot for the life of me figure it out. (grade of evidence: basic science) There is an absence of clinical evidence and clinical experience for the use of decellularized osteochondral allograft plugs. 23 $427 28102 Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with iliac or other autograft (includes obtaining graft Coding Guidlines. Surgical treatment of a tibial osteochondral defect with debridement, marrow stimulation, and micronized allograft cartilage matrix: report of an all-arthroscopic technique. PROCEDURE PERFORMED: Left ankle arthroscopy with debridement and exostectomy. Allograft availability and lower healing rate than autograft Feb 11, 2022 · The prevalence of osteochondral lesions of the talus is 0. 76 Query: Osteochondral Defect in the Talus. The purpose of this technical note was to describe the details of arthroscopic debridement Jul 23, 2020 · Osteochondral lesions that compromise the ankle are rare, with an incidence between 0. If a cartilage defect is too large for an autograft, an allograft may be considered. Code 27416 (Osteochondral autograft(s), knee, open (e. Jun 1, 2024 · osteochondral grafting (osteochondral autograft transplantation, autologous chondrocyte implantation, bulk allograft) indications size > 1 cm and displaced lesions, shoulder lesions The CPT codes represent the placement of CartiMax ankle including exploration, drainage, or osteochondral allograft (e. to an ankle arthrotomy may provide adequate visualization of the osteochondral defect (Fig 1). This technique reports an arthroscopic OATS procedure of the lateral femoral condyle with donor-site backfill using an osteochondral allograft plug. 871-M24. , CT scan, MRI) 33 2. Osteochondral Allograft Convenience Kit provides surgeons with an option for addressing osteochondral defects of various geometries and sizes. Cartiform* viable osteochondral allograft is composed of viable chondrocytes, chondrogenic growth factors, and extracellular matrix proteins. However, this promotes healing through the formation of fibrocartilage, which is not ideal in the setting of repetitive weight-bearing and compressive Desai S. While there is abundant literature about osteochondral allograft transplantation in the knee, there are few papers about this procedure in the Methods. • CPT® codes 29874 (Surgical knee arthroscopy for removal of loose body or foreign body) and 29877 ((g py gSurgical knee arthroscopy for debridement/shaving of articular cartilage) should not be reported with other knee arthroscopy codes (29866-29889). 97% chondrocyte viability after two years of storage at -80C 1; Cost effective, single stage cartilage allograft; Trimmable and flexible graft that allows for easy allograft manipulation during implantation May 16, 2016 · Copious irrigation of the ankle joint was performed. Asymptomatic lesions and incidentally found lesions are best treated conservatively; however, acute displaced osteochondral fragments may require surgical treatment Apr 5, 2019 · Intercalary allograft transplantation (+20933 and +20934) also uses human tissue to reconstruct bone defect(s) after tumor resection. Contact your local Arthrex representative for additional information. For arthroscopic osteochondral talus graft, CPT code 29892 should be used, and for open osteochondral allograft or repairs with industrial grafts, CPT code 28899 is appropriate. While osteochondral autografting is primarily performed on the femoral condyles of the knee, osteochondral grafts have also been used to repair chondral defects of the patella, tibia, and ankle. Osteochondral allograft transplantation in the ankle: a review of current practice Daniel J Fuchs, Anish R Kadakia Department of Orthopaedic Surgery, Northwestern Memorial Hospital, Northwestern University, Chicago, IL, USA Abstract: Osteochondral allograft transplantation is a technique that was first developed to treat cartilage pathology in the knee. the orthopedic physician excised a bone lesion of the tibia and closed it with an allograft-27638. per coding guidelines you can only code for the allograft as the excision is inclusive. Physician CPT® Code Description Knee 27415 Osteochondral allograft, knee, open 29867 Arthroscopy, knee, surgical; osteochondral allograft (eg, mosaicplasty) Ankle Osteochondral Allograft Transplantation System (OATS) of the Ankle What is OATS of the Ankle? OATS of the ankle is a surgical procedure to treat Osteochondral Lesions of the Talus (OCL) or Osteochondritis Dissecans (OCD). Trabecular Metal™ Total Ankle Coding Feb 8, 2024 · Juvenile chondrocytes (healthy cartilage cells) are particularly useful for an osteochondral allograft because they are much more efficient at generating articular cartilage than mature tissue. This code will cover the right ankle arthroscopy, OATS procedure, medial talus, with harvest from right knee. Recent studies have stratified outcomes according to location and etiology of the chondral or osteochondral defect. , intercalary). Apply distraction to the tibiotalar joint, if needed, to . 10 N/A 5115 – Level 5 MSK Procedures $12,552. From what you describe, he did a Drilling (K Wire placement), then an Internal Fixation Procedure. Would you use CPT 29999 or 29892. For extensive loss of bone, reconstruction with bulk allograft replacement may be an option. Two independent reviewers performed a search of the Medline database on PubMed from 2000 to January 2012, using the terms “osteochondral allograft”, “cartilage replacement”, “fresh osteochondral implantation”, “allografting”, “ankle arthritis”, and “ankle Feb 6, 2017 · The extremity is elevated, and the tourniquet is inflated. Code Description CPT. Physician CPT® Code Description Lower Joints 27415 Osteochondral allograft, knee, open 29867 Arthroscopy, knee, surgical; osteochondral allograft (eg, mosaicplasty) This video demonstrates the trochlear osteochondral shell allograft technique combined with a patellar cylindrical osteochondral allograft transplantation, revision tibial tubercle osteotomy, and medial patellofemoral ligament reconstruction (MPFL) to treat trochlear dysplasia in the setting of chondral damage and chronic patellar instability. Aug 21, 2019 · I need help with the above CPT. Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; acute $843. (ORIF) But I just seem to think that is stretching it a bitAny Suggestions??? PREOPERATIVE DIAGNOSIS: Right knee osteochondral defect medial femoral condyle. Shoulder . Step 2 - Defect sizing. Biovance ® Human Amniotic Membrane and Interfyl ® Connective Tissue Matrix 1-844-963-2273 (prompt 5) Cartiform ® Viable Osteochondral Allograft the articular surface of the joint. 27415 Osteochondral allograft, knee, open 27416 Osteochondral autograft(s), knee, open (e. Ligament allograft (e. , mosaicplasty) 29885 CPT codes not covered for indications listed in the CPB: Autologous cartilage chip transplantation, Osteochondral autografts/allografts for the treatment of osteochondral lesions of the tibial plafond - no specific code: 27412: Autologous chondrocyte implantation, knee: 28446 Jul 25, 2023 · There have been different procedures described for the treatment of cartilage defects. Osteochondral allografts (Cadaver grafts) have been used to treat large talar lesions with some success. 5 out of 100 ankle sprains, although reports of their prevalence in ankle injuries have been as high as 50% of acute ankle sprains and fractures . In 90 percent of Our customers are able to access coding and reimbursement information so that they can better understand how Arthrex products fit into health care coding and reimbursement reporting. The most important finding of a recent review of the literature by van Djik et al. CPT code 27415 and CPT code 29867 are designated as device-intensive procedures. Jul 27, 2018 · Approximately 50% of ankle sprains and up to 73% of ankle fractures result in some level of cartilage injury, and there are over 2 million ankle sprains alone per year. The Current Procedural Terminology (CPT ®) code 27899 as maintained by American Medical Association, is a medical procedural code under the range - Other Procedures on the Leg (Tibia and Fibula) and Ankle Joint. 5% according to different series. 2 Jul 2, 2018 · Fresh osteochondral allograft (OCA) transplantation is a successful single-stage procedure for the treatment of symptomatic cartilage defects of the knee. In the case of osteochondral autografts, 1 or more small osteochondral plugs are harvested from non-weight-bearing sites, usually from the knee, and press fit into a prepared site in the lesion. CPT Codes CPT codes: Code Description 27415 Osteochondral allograft, knee, open 27416 Osteochondral autograft(s), knee, open (e. 11. The main benefit of OAT is that these grafts maintain type-II collagen, to reproduce the mechanical, structural, and biochemical properties of the original hyaline articular Nov 23, 2015 · the CPT codes tracked to each defined case category. 2015 Mar;23(3):860-7. He wants Sep 11, 2019 · Osteochondral lesions of the talar head can be classified into 4 types according to their location. g. Physical examination and imaging are crucial for diagnosis and characterization of an OLT. Codingline Responses: The arthroscopic code is CPT 29891 (arthroscopy, ankle, surgical; diagnosis codes, including modifiers where applicable. [1][2][3] • Viable osteochondral allograft (e. Lateral defects are produced by inversion and dorsiflexion of the ankle (usually anterior, affecting 3 and 6 talar 28446 29892 The use of CPT 29892 for arthroscopic osteochondral talus graft is per CPT instruction and is regardless of whether using an allograft or autograft; however, CPT codes 27899 or 28899 may also be seen. PROCEDURES: 1. Arthroscopic shaving chondroplasty, left patellofemoral joint (29877). Allograft: 28899: Elbow Autograft: 24999 29999 For osteochondral graft of the elbow, the same unlisted code Nov 9, 2021 · The osteochondral autograft transfer system (OATS) procedure is at the forefront of cartilage restoration surgeries of the knee, offering superior return to sport rates and long-term functionality. , mosaicplasty) J1 5115 $12,314. (3) Subchondral bone depth is preferred at 4 to 6 mm depth (total plug depth ∼5-8 mm Jul 31, 2023 · Injuries involving subchondral bone and chondral tissues are found in up to 63 to 66% arthroscopic procedures and represent a challenging entity to treat with an important propensity to progress to osteoarthritis. These allografts are positioned between joints (i. The state of the art of allografts with regard to basic science, procurement and storage methods, immunogenicity, generally accepted indications and contraindications, and the rationale of the allografting procedure have been described. Cartilage viability is one of the most important factors for successful clinical outcomes after transplantation of osteochondral allografts. 23 5113 Dec 12, 2019 · Arthroscopic techniques for anterior talofibular ligament (ATFL) repair and reconstruction have been developed in recent years. Allografts, however, are taken from a cadaver donor instead of the patient's own body. At issue is whether the lesion was completely "stable" or mildly "unstable" (slightly loose and wobbly, but not completely displaceable or mobile). ProChondrix CR is a cryopreserved, fresh osteochondral allograft that contains live cells and other biological components for the repair of damaged cartilage tissues. 071-M87. CPT 28102 or 28103. (B) A lateral femoral condyle osteochondral allograft (JRF Ortho) is measured and prepared. Welcome to Zimmer Biomet DeNovo NT Graft is an FDA-listed tissue product used for knee, hip, ankle and shoulder cartilage restoration since 2007 with no reports of graft rejection or disease transmission. M87. Hi. Potential complications from unfilled donor site Oct 17, 2015 · Over the past decade, osteochondral allograft transplantation has soared in popularity. CPT Code 27705, Surgical Procedures on the Leg (Tibia and Fibula) and Ankle Joint, Repair, Revision, and/or Reconstruction Procedures on the Leg (Tibi Mar 18, 2021 · Typical HCPCS Codes C1762 – Billing code for allograft Typical Revenue Codes (for form UB-04) 278 – Other implants CPT Modifiers Physicians may bill modifiers to indicate that a procedure performed has been altered by some specific circumstances, but not changed in its definition or code. , mosaicplasty) (includes harvesting of autograft[s]) 28446 Open osteochondral autograft, talus (includes obtaining graft[s]) 29866 Arthroscopy, knee, surgical; osteochondral autograft(s) (e. Here fresh, fresh frozen or cryopreserved cadaveric samples are used to fill the defects. That makes now the perfect time to study up on how to choose between osteochondral graft codes 27415, 27416, 29866 and 29867. 3 , 4 , 5 In addition to Because there is no category I CPT code that describes the procedure using allograft, we must report the service using code 27899 (unlisted procedure, leg or ankle). Mosaicplasty using autologous osteochondral transfers have been shown to have good success in treating osteochondritis dissecans of the talus. 87 $9719. Use these strategies, and you-re sure to choose the right code every time. 94. Unipolar lesions generally have Osteochondral allograft (OCA) transplantation, however, is a single-stage technique that utilizes full thickness, viable hyaline cartilage, avoids donor site morbidity, permits resurfacing of large defects, and potentially yields a more natural, matching contour of the native recipient surface anatomy. ** placement of the arthroscope ** noted to be hypertrophic synovitis and fibrosis to the ankle joint, both medially, laterally and anteriorly ** two loose bodies or exostosis noted within the anterior ankle joint Osteochondral lesions of the talus (OLTs) are characterized by damage to the articular cartilage of the talus and its underlying subchondral bone. These lesions typically occur after a traumatic injury and are best diagnosed on MRI. 873 – Joint derangement, ankle. Please Please help!!! PREOPERATIVE DIAGNOSIS: Osteochondral fracture anterolateral right talus. 56 N/A 5115 – Level 5 MSK Procedures $12,552. Allografts often are used as a salvage treatment when other cartilage repair procedures have failed. 732. Code 28446 could be used for comparison for physician work, but it is reasonable to expect a reduced payment because the work of harvesting the autograft is not required or Osteochondral fractures are relatively uncommon injuries that typically present after an acute or subacute traumatic injury. Normally I would go for 27415 or 27416, but neither an allograft or autograft was used. Osteochondral grafts are used to repair full-thickness chondral defects involving a joint. 44,61,70 Classic teaching is that lateral OLTs are more likely due to trauma than medial lesions, with 94% of lateral lesions and 62% of medial lesions being caused by trauma manipulated human tissue graft, the Chondrofix Osteochondral Allograft undergoes a proprietary processing protocol resulting in a shelf-stable graft that retains relevant inherent structural properties and provides an effective alternative to fresh allograft or autograft 16. , mosaicplasty) (includes The Current Procedural Terminology (CPT ®) code 28446 as maintained by American Medical Association, is a medical procedural code under the range - Fracture and/or Dislocation Procedures on the Foot and Toes. I picked 23615 but what do I use for the allograft? The op notes states: The patient had a large void in the metaphyseal region. Knee Surg Sports Traumatol Arthrosc. 4. 19 Research conducted utilizing OCA Nov 20, 2023 · We present an evidence-based approach to optimize the biologic incorporation of osteochondral allografts: (1) The donor graft is gradually rewarmed to room temperature to reverse the metabolic suppression from cold storage. For the OATS on the ankle or foot, the only coding option for you is 29999 (Unlisted procedure, arthroscopy). Ankle instability 35 4. 8. POSTOPERATIVE DIAGNOSIS: Osteochondral injury, left lateral femoral condyle with loose osteochondral fragment. We simultaneously performed anatomical arthroscopic ATFL repair and reconstruction using a free tendon graft. , Cartiform, CartiMax, ProChondrix) Coding Information This following list of codes are for informational purposes only and may not be all-inclusive. Osteochondral allograft transplantation is an effective procedure for the treatment of large OLTs using mature hyaline cartilage allograft which provides an anatomically articulating surface and prevents ankle joint arthrosis by avoiding excessive weight on the remaining portion of the talus [128 FRESH OSTEOCHONDRAL ALLOGRAFT FREQUENTLY ASKED QUESTIONS 3. Outcomes have generally been good, but cartilage thinning, subchondral remodeling, and tissue Jul 1, 2018 · The source of osteochondral allograft plugs for the ankle should come from the ankle, not the knee. [ 14 ] is that BMS was identified as the best treatment option. Feb 6, 2017 · Therapeutic arthroscopy with microfracture leads to fibrocartilaginous repair and is an effective treatment of osteochondral lesions of the talus. On some occasions, defects are so large that concerns of donor-site morbidity can prevent reconstruction via OAT or mosaicplasty procedures. e. This is important because poor cartilage integration between plugs can contribute to reduced durability of the osteochondral graft . For osteochondral lesions of the talus or the tibia, a fresh osteochondral allograft transplant can be fashioned to match a specific defect and is useful for large, cystic or uncontained lesions. 2. 64 This lower incidence may be related to the concave shape of the inferior articular surface of the tibia and to the greater resistance of the tibial cartilage to compression when compared with the talar cartilage Procedure Codes for Hindfoot Excision CPT® Code Description 2021 Total RVUs 2021 Medicare National Average Payment 28100 Excision or curettage of bone cyst or benign tumor, talus or calcaneus; 12. 5 if the px was for a child. CPT® Code Description Internal Fixation (cont. All 12 allografts . 555-563. %PDF-1. CPT: 27415 Osteochondral allograft, knee, open 27416 Osteochondral autograft(s), knee, open (eg, mosaicplasty) CPT 1 Code Setting Facility Medicare Medicare HCPCS (HOPD Setting APC & APC National National Code Code Description and ASC) (Office) Description Average Average . Jul 26, 2023 · Background Extensive literature exists about the treatment of ankle osteochondral lesions, but there is no specific review of retrograde drilling, despite its common application. maintain access and visibility to the osteochondral defect throughout the procedure. Although long-term data are lacking, studies in Aug 28, 2013 · Restoring articular cartilage can be achieved by osteochondral autograft or allograft transplantation (OATS, mosaicplasty), ACI and MACI and fresh osteochondral allografts (FOCAT). , mosaicplasty) 29885 Autologous chondrocytes, osteochondral allografts and autografts CPT 27412 Autologous chondrocyte implantation, knee 27415 Osteochondral allograft, knee, open [when specified as osteochondral allograft] 27416 Osteochondral autograft(s), knee, open (eg, mosaicplasty) includes harvesting of autograft[s]) 29866 Aug 31, 2015 · Over the past 15 years, this technology has been translated to the treatment of osteochondral lesions and end-stage arthritis of the ankle. 43 $559. It is important to verify the correct code is being used to help ensure insurance authorization. 131 In 2011, Berlet et al. Causes. Drainage and debridement for septic arthritis 34 3. , Cadaver): A bone and cartilage plug may also be obtained from a cadaver and transplanted into the OLT. PROCEDURE: 1. Osteochondral Allograft Transplantation ProChondrix CR is an off-the-shelf, cryopreserved osteochondral allograft used to treat surface cartilage lesions. 076 – Idiopathic aseptic necrosis of ankle and foot. When the defect is full thickness, the chances of “self-repair” are small. Basic science and clinical studies support the safety and efficacy of the procedure. A full diagnostic arthroscopy is performed, and then attention is turned to the osteochondral defect. Fresh OCA’s allow the surgeon to transplant mature, hyaline cartilage with viable chondrocytes and subchondral bone in a single procedure. The aim of this review is to provide an update on actual applications and It is the provider’s responsibility to determine the appropriate codes and modifiers to be submitted. depending on specific dx. 2016;55:279-82. , osteochondritis dessicans of talus) while performing an ankle arthrotomy? Troy Wentling York, PA. This location is the third in frequency, after knee and elbow. 171-M24. Survivorship at 5 years While there is an abundant literature about osteochondral allograft transplantation in the knee, there are few papers about this procedure in the talus 8-16. A brief discussion on current surgical options for osteochondral defects of the Oct 5, 2020 · The biggest advantage of osteochondral allografts is that the interface between multiple osteochondral autograft plugs in large lesions is eliminated. The use of fresh-stored Jun 6, 2021 · [11,20,21] Cartilage replacement, such as osteochondral autograft/allograft transplantation (OAT), can replace the talus osteochondral lesions with hyaline cartilage. Much denser than fully mature cartilage, immature cartilage is packed with cells, which begin to multiply soon after implantation of the cartilage graft. Berry, MD,Frederick Azar, MD Orthopedic Coding Guides for Asc's Lolita M Jones,2005 Advanced Reconstruction: Knee Jay R. Berry, MD,Frederick Azar, MD,2018-08-30 The Aug 17, 2016 · Osteochondral lesions of the distal third of the tibia are unusual findings, appearing in 2. , mosaicplasty) (includes harvesting of autograft[s]) 29866 Arthroscopy, knee, surgical; osteochondral autograft (s) (e. • HCPCS code G0289 (Surgical knee arthroscopy for removal of loose body, foreign body, CPT Codes / HCPCS Codes/ ICD-10 Codes; Code Code Description; Other CPT codes related to the CPB: 21240 - 21243: Arthroplasty, temporomandibular joint: 23000 - 23921: Non arthroscopic shoulder surgery: 27415: Osteochondral allograft, knee, open: 27430: Quadricepsplasty (eg, Bennett or Thompson type) 27486: Revision of total knee arthroplasty Jan 2, 2009 · Hopefully to get you started. A range of codes indicates there are several options available. It involves the transfer of healthy cartilage to replace the damaged cartilage and restore the normal function of the foot. J Foot Ankle Surg. Sports Health: A Multidisciplinary Approach, 9(6), pp. No superior treatment for OLTs exists. All the studies addressing fresh osteochondral allograft procedures in the ankle joint were identified. Over the past 15 years, this technology It is the provider’s responsibility to determine the appropriate codes and modifiers to be submitted. Left ankle arthritis. Here is the operative report. Anatomical Region CPT Code CPT Code Description Knee 27415 Osteochondral allograft, knee, open 29867 Arthroscopy, knee, surgical; osteochondral allograft (e. 7 %âãÏÓ 183 0 obj > endobj 207 0 obj >/Filter/FlateDecode/ID[990D388602FA4EC3B30335B8FD435DAB>]/Index[183 42]/Info 182 0 R/Length 117/Prev 311943/Root 184 Osteochondral Allograft Convenience Kit - Zimmer Biomet Osteochondral Autograft Transfer (OAT) OAT means that cartilage from one part of the joint is transferred to another. , mosaicplasty) 29885 • decellularized osteochondral allograft implant (e. Deleted codes and codes which are not effective at the time the service is rendered may not be eligible for reimbursement. shelf-stable graft that retains relevant inherent structural properties and provides an effective alternative to fresh allograft or autograft for the repair of osteochondral lesions. Although long-term studies reveal reliable improvements in patient-reported outcome scores and graft survival, the limitations of the procedure include graft availability and timely use prior to expiration. The majority of OLTs, as many as 85%, occur after a traumatic injury to the ankle joint. 173 – Other articular cartilage disorders, ankle. A noninvasive ankle distractor (Smith and Nephew GUHL noninvasive ankle distractor) is attached to the side of the operating table and set to 30 foot-pounds of inline traction using a limb positioner (Smith and Nephew Spider 2; Fig 1 B, Video 1). Jun 20, 2022 · Figure 3 Preparation of the left knee osteochondral allograft of the lateral femoral condyle. What Fresh Osteochondral Allografts are available? ATL80 Ankle Talus, Left ATR80 Ankle Talus, Right FCA80 Femoral Hemicondyle, Left Lateral FCC80 Femoral Hemicondyle, Right Medial Feb 20, 2015 · Osteochondral injury, left lateral femoral condyle with loose osteochondral fragment. Mosaicplasty is a little different in technique as the grafts are smaller and defects exist in the cartilage surface [ 44 ]. 3. Can anyone verify that? Thanks, May 22, 2014 · Help, Need Procedure Coding help. Typical ICD-10 Codes CPT Codes CPT codes: Code Description 28446 Open osteochondral autograft, talus (includes obtaining graft[s]) ICD-10 Procedure Codes ICD-10-PCS procedure codes: Code Description 0QQL0ZZ Repair Right Tarsal, Open Approach 0QQM0ZZ Repair Left Tarsal, Open Approach 0QQL3ZZ Repair Right Tarsal, Percutaneous Approach Jan 4, 2012 · The Scope code would be 29879, the closest Open I am seeing is a 27415 or 27416 but that is with a Graft, I have also read that due to the defect / fragments it could be a fracture. M24. 002 per 1000 persons and they occur in 6. gqhcc mkb ezy wfukum fgdzwbs okk ufebdjqg wxneluj ilikl roqtbu