I have recently been given the task of doing old things that people either forgot about or just couldn’t come up with anything. I did google a bunch of different codes this could be I have 38212 or 38206 or 38241. We don’t think it would even be covered by insurance but I need to at least bill something, I am not even sure that when they injected this into the knee then if you would use a 20610 with it. Thanks for all the information anyone can shine on this dilemma I am dealing with.
Scott K. CPC

PROCEDURE: I identified him, I marked his right knee. He was brought back to the examination room and placed supine on the table. Using an alcohol swab, I sterilized points on the right and left lateral abdomen. I used 10 cc of lidocaine with epinephrine to sterilize these two locations. I then sterilized his entire abdomen with ChloraPrep. He was then sterilely draped out over his abdomen.

Next, two small stab incisions were made on the left and right lateral side of his abdomen. I then used sterile saline with epinephrine to inject into the fatty layer between the skin and the rectus abdominus over his abdomen, left and right side. A total of 180 cc were used on the left and 180 cc on the right. There was lidocaine in this mixture. I then allowed 15 minutes for the lidocaine to work and the fat to separate to some degree with the saline.

Then, using the blunt 14-gauge Lipogems needle, I harvested 180 cc of fat getting 90 cc from the left, 90 cc from the right. He tolerated this portion of the procedure well with no complications. The fat cells were then separated using the filtering system from Lipogems. Serum-type fluid and mature emulsified fat were separated from the immature fat. The mature fat then went through a second filtering process using the metallic marbles to break up the fat. I got a total of 17.5 cc of stem cells with immature fat to inject. In the meantime, Tegaderm and 4x4s were placed over his two small stab incisions and two six-inch ACE wraps were applied around his waist for compression. I then sterilized the anterolateral aspect of his right knee with ChloraPrep. I then injected the 17 cc of stem cells into the right knee. A Band-Aid was placed. He tolerated the procedure well without complication.

DIAGNOSIS: Genu varum, primary osteoarthritis, right knee.

PLAN: I will see the patient back in six weeks for a followup clinical examination, sooner if he is having problems. Discharge instructions were provided. Most importantly, no NSAIDs after this procedure. The patient verbalized understanding