Medicare Benefits Schedule - Item 49703

Surgery of ankle joint, by arthroscopic means, including any of the following (if performed):

(a) cartilage treatment;

(b) removal of loose bodies;

(c) synovectomy;

(d) excision of joint osteophytes;

other than a service associated with a service to which another item in this Group applies if the service described in the other item is for the purpose of performing a procedure on the ankle by arthroscopic means (H)

Multiple Operation Rule

(Anaes.) (Assist.)

Fee: $697.20 Benefit: 75% = $522.90

(See para TN.8.196, TN.8.199, TN.8.202 of explanatory notes to this Category)

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• Removal of prominent bone or osteophytes can be billed as an isolated procedure under 48430 or when through a separate incision to other procedures. 
• When an osteotomy is performed through the bone to correct a deformity then the appropriate number is chosen from 48400, 48403, 48406, 48409, 48418 or 48421. 
• Not to be used when performing joint arthroscopy (49703, 49730 or 49732), bunion correction (49827, 49830, 49833, 49836, 49837 or 49838), neurolysis (39330), wound debridement (30023) or an arthrodesis procedure unless performed at a site separate to the excluded items.

Related Items: 39330 48400 48403 48406 48409 48421 48430 49703 49827 49833 49836 49837 49838

• Ray: From the tip of a digit to the proximal metatarsal base of that digit, including phalanges and metatarsal bones.
• Hindfoot joints: Consist of subtalar, talonavicular and calcaneocuboid joints.
• Hindfoot bones: Consist of the calcaneus, talus, navicular and cuboid.
• Midfoot joints: Consist of naviculocuneiform and tarsometatarsal joints.
• Midfoot bones: Consist of cuneiforms.
• Major ankle tendons: Consist of the Achilles’, tibialis anterior, tibialis posterior, peroneal (both longus and brevis), extensor hallucis longus and flexor hallucis longus tendons.
• Flexor tendon: Both the flexor digitorum longus and flexor digitorum brevis tendons.
• Extensor tendon: Both the extensor digitorum longus and extensor digitorum brevis tendons.
• Reconstruction of a tendon: Treatment of a degenerative tendon where more than end-to-end repair of tendon rupture is involved.
• Transtarsal amputation: Involves amputation of the foot through the tarsal or metatarsal bones, or through the tarsometatarsal joints.
• Joint debridement: Removal of osteophytes, removal of part of the joint, and removal of intervening soft tissue, loose bone ossicles or fragments from one or both sides of a joint.
• Primary treatment: Acute and first management of an injury or pathology. 
• Delayed or secondary treatment: Subsequent to primary treatment, or occuring after the normal expected healing time for the relevant tissue.
• Revision procedure: A repeat operation to replace or compensate for a failed implant, correct a painful non-union of fracture or fusion, correct malunion, reconstruct a failed soft tissue procedure, or correct undesirable complications of previous surgery.
• Operative exposure: Includes (if performed) arthrotomy and/or arthroscopy of joint, washout of joint, removal of loose fragments or loose bodies, synovectomy of neurovascular bundle and closure of capsule.
• Radical plantar fasciotomy or fasciectomy: Involves the partial or complete removal of the plantar fascia, but does not involve simple release of the fascia.

Related Items: 44338 44342 44346 44350 44354 44358 44359 44361 44364 47063 47066 47069 47573 47595 47597 47600 47603 47612 47615 47618 47621 47624 47630 47637 47639 47648 47657 47663 47666 47672 47678 47904 47906 47915 47916 47918 48400 48403 48430 48433 48435 49703 49706 49709 49712 49715 49716 49717 49718 49724 49727 49728 49730 49732 49734 49736 49738 49740 49742 49744 49760 49761 49762 49763 49764 49765 49766 49767 49768 49769 49770 49771 49772 49773 49774 49775 49776 49777 49778 49779 49780 49781 49782 49783 49784 49785 49786 49787 49788 49789 49790 49791 49792 49793 49794 49795 49796 49797 49798 49800 49803 49806 49809 49812 49815 49818 49821 49824 49827 49830 49833 49836 49837 49838 49839 49845 49851 49854 49857 49860 49866 49878 49881 49884 49887 49890

• Arthroscopy of joint includes associated intraarticular pathology treatment, such as treatment of cartilage, loose bodies, synovectomy, scar removal, and excision of exostosis by arthroscopic means.
• In cases of inflammatory synovitis or osteochondral defect >1.5cm², it is appropriate to use item 50312.

Related Items: 49703 49730 49732 50312