Qtr 1 Physician IRR 2017 MSK (Joint Surg) case study # 3

Asuris Commercial (Use Cambia on Crystal Ball)

47 year old male with prior authorization request for arthroscopic knee meniscectomy , CPT 29881.

The patient sustained an acute injury with “disabling pain and loss of function”.

Symptoms include blocked range of motion, giving way/buckling of the knee and painful clicking/popping during weight bearing activities of daily living and/or work.

Physical Examination shows positive McMurray test, (+)joint effusion with limited ROM compared to other side and joint line tenderness.

MRI shows frank meniscal tear.

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