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Autologous chondrocyte implantation (ACI) is a specialized surgical procedure aimed at repairing damaged articular cartilage in the knee joint. This technique is particularly beneficial for patients suffering from cartilage defects, which can lead to pain, swelling, and impaired joint function. The procedure involves the use of the patient's own chondrocytes, which are specialized cells responsible for the maintenance and repair of cartilage. The most common sites within the knee that are treated using ACI include the distal femoral condyles, the trochlea, and the patellofemoral joint. Prior to the implantation, chondrocytes are harvested from the patient through a separate procedure that involves taking biopsies of the synovial tissue in the knee. This harvesting process is crucial as it provides the necessary cells for the subsequent implantation. After the chondrocytes are collected, they undergo a laboratory process known as cellular expansion, where the cells are multiplied to ensure there are enough for effective implantation. Once the chondrocytes have been sufficiently expanded, the patient returns for the implantation procedure, which involves a series of meticulous surgical steps to ensure proper placement and integration of the chondrocytes into the damaged area of the knee.
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The autologous chondrocyte implantation procedure is indicated for patients with specific conditions affecting the knee joint, particularly those involving cartilage defects. The following are the primary indications for this procedure:
The autologous chondrocyte implantation procedure involves several critical steps to ensure successful cartilage repair. The following outlines the procedural steps:
After the autologous chondrocyte implantation procedure, patients typically require a period of rehabilitation to facilitate recovery and optimize outcomes. Post-procedure care may include pain management, physical therapy, and gradual weight-bearing activities as advised by the healthcare provider. Patients are monitored for any signs of complications, and follow-up appointments are scheduled to assess the healing process and the integration of the implanted chondrocytes. The expected recovery time can vary, and adherence to the rehabilitation protocol is crucial for achieving the best possible results.
| Short Descr | AUTOCHONDROCYTE IMPLANT KNEE | Medium Descr | AUTOLOGOUS CHONDROCYTE IMPLANTATION KNEE | Long Descr | Autologous chondrocyte implantation, knee | 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) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | 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) | P1A - Major procedure - breast | 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. | 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. | AF | Specialty physician | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 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) |
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| 2005-01-01 | Added | First appearance in code book in 2005. |
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