Severe chondromalacia patellar, right knee

From the health record of a 4-year-old patient admitted for outpatient surgery on his knee:

Operative Report

Preoperative Diagnosis: Severe chondromalacia patellar, right knee

Postoperative Diagnosis: Severe chondromalacia patella and medial femoral condyle, right knee

Procedure Performed: 1. Arthroscopy

                                        2. Chondroplasty/debridement of the patella and medial femoral condyle

                                        3. Lateral retinacular release, right knee

Indications: This 47-year-old male has a history of severe patellofemoral and anteromedial joint line pain. This has been treated with anti-inflammatory medications and physical therapy with persistent symptoms. He has the tightness of his lateral retinaculum and patellofemoral pain. He presents now for surgical treatment after failed conservative management. 

Details of Operation: The patient was brought to the operating room and placed on the operating table in a supine position. After the installation of successful general anesthesia, the right knee was examined. The range of motion was full; no laxity to stress testing was noted. Marked patellofemoral crepitus was noted. The leg was then placed in the arthroscopic leg holder, and the knee was sterilely prepped and draped. The knee was injected with a total of 30 cc of 0.25 percent Marcaine with epinephrine. Standard arthroscopic portals were established. There were grade III changes over the superior aspect and medial aspect of the patella. The trochlear groove of the femur was softened and minimally fissured. The medial compartment was entered and showed grade III chondromalacia over the majority of the weight-bearing surface of the medial femoral condyle. The tibial plateau was mildly softened, as was the medial meniscus, and minimal chondromalacia of the tibial plateau. At that point, a full radius resector was placed, and a chondroplasty debridement was carried out of the patella and medial femoral condyle. An internal lateral retinacular release was then carried out using arthroscopic electrocautery to help decompress the patellofemoral area. The patient returned to the recovery room without complications.

What are the correct ICD-10-CM and CPT code assignments for this outpatient surgical case?

a. M22.41, M25.861, 29873-RT, 29877-RT-59

b. M22.41, M25.861, 27425-RT

c. M22.41, 29877-RT

d. M22.41, M25.861, 29999-RT, 29877-RT

9.51) The patient is a 23-year-old female who has been diagnosed with left distal femur osteosarcoma on biopsy and has undergone preoperative chemotherapy. Risks, benefits, complications, and alternatives of resection and reconstruction were discussed with her, and consent was obtained. The patient was seen in the preoperative area, and a history and physical examination were performed. Consents were reviewed. She received preoperative antibiotics, and a foley catheter was placed. Both legs were prepped and draped out. An external incision was made on the anteromedial aspect of the left thigh, extending toward the anterior aspect of the proximal tibia, including excision of the previous biopsy tract. An osteotomy was performed, parts of the posterior cortex were curetted, and marrow was removed and passed off to the pathologist for evaluation. Both of these were read on frozen sections as normal and containing no malignant tissue. With these findings known, the remaining posterior attachments to the femur were dissected/transected. The femoral artery extending toward the popliteal space was carefully explored and retracted, and any branches of the tumor were either clipped or suture ligated. The tumor was dissected, and the resection was carried out under a tourniquet at 270 mmHg. Postoperatively, the foot showed adequate blood flow with a palpable dorsalis pedis pulse. The patient was extubated. She will be admitted for postoperative pain control as well as rehabilitation and discharged when stable.

What is the code assignment for the services of the surgeon? ICD-10-CM and CPT codes: