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Osteochondral autografts are specialized grafts that consist of both bone and cartilage, which are harvested from the patient's own knee tissue. This procedure is particularly relevant for addressing defects in the articular surface of the knee, which can occur due to injury or degenerative conditions. The technique employed is known as mosaicplasty, which involves the meticulous harvesting of small cylindrical plugs of osteochondral tissue from nonweight-bearing areas of the knee. These plugs are then transplanted into the damaged areas of the knee joint to restore the integrity of the articular surface. The procedure is performed through an open surgical approach, which allows for direct visualization and access to the knee joint. A skin incision is made over the affected compartment of the knee, followed by an incision of the joint capsule (arthrotomy) to expose the damaged tissue. The damaged cartilage and underlying bone are carefully debrided to prepare the site for the transplant. The harvesting of the autograft is done with precision, ensuring that the donor site is approached perpendicularly to the articular surface to obtain viable osteochondral tissue. The recipient site is then meticulously prepared to match the size and shape of the harvested graft, ensuring a proper fit for optimal healing and integration. This process continues until the defect is adequately filled or until no further healthy tissue can be harvested from the donor site.
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The procedure of osteochondral autograft(s) for the knee is indicated for various conditions that result in damage to the articular surface. These indications include:
The procedure for osteochondral autograft(s) involves several critical steps to ensure successful grafting and restoration of the knee joint. The steps are as follows:
After the procedure, patients typically require a period of rehabilitation to ensure proper healing and recovery. Post-operative care may include pain management, physical therapy, and gradual weight-bearing as tolerated. The recovery process is closely monitored to assess the integration of the graft and the restoration of knee function. Follow-up appointments are essential to evaluate the healing progress and to address any complications that may arise during the recovery period.
| Short Descr | OSTEOCHONDRAL KNEE AUTOGRAFT | Medium Descr | OSTEOCHONDRAL AUTOGRAFT KNEE OPEN MOSAICPLASTY | Long Descr | Osteochondral autograft(s), knee, open (eg, mosaicplasty) (includes harvesting of autograft[s]) | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 162 - Other OR therapeutic procedures on joints |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2008-01-01 | Added | First appearance in code book in 2008. |
| 1985-12-31 | Deleted | Code deleted. |
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