5 Knee Arthroscopy Coding & Billing Tips. A second line (B) is drawn parallel to line A, and is placed at the lateral trochlear ridge. In this article (part 4), the basics of operative knee arthroscopy are reviewed including chondroplasty and meniscectomy. A provider/supplier shall not report multiple HCPCS/CPT codes if a . Diet as tolerated B. 29884 - Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure) Note: This code is commonly assigned for debridement of "Cyclops lesion" which is localized arthrofibrosis which generally develops after ACL reconstruction. CPT Code information is available to subscribers and includes the CPT code number, short description, long description, guidelines and more. Knee Arthroscopy and Synovectomy Day of surgery A. CPT code 29876 may be reported for a medically reasonable and necessary synovectomy with another arthroscopic knee procedure on the ipsilateral knee if the synovectomy is performed in two compartments on which another arthroscopic procedure is not performed. Of the 39 patients, 36 were placed in full-course supine position (the affected knee can be hanging on the bed) and 3 were initially placed in supine position and then in prone . 2013; 21: 415 . occurs, coding 29827 (arthroscopic rotator cuff repair) with 29819-59 is permissible. CPT 29881, Under Endoscopy/Arthroscopy Procedures on the Musculoskeletal System. Rationale: This example shows the provider performed major synovectomy due to inflamed synovium. synovectomy) 29822 bundles, but not 29823 (limited vs. extensive debridement . In the 2021 CPT Manual, the subsection guidelines will now state "Arthroscopic removal of loose body (ies) or foreign body (ies) (i.e. These updated guidelines apply to all the different joints, shoulders, elbows, hips, knees, ankle and subtalar joints. Only the medial compartment will have a final synovectomy reporting of CPT 29875. CPT code information is copyright by the AMA. . CPT Code: 29885Arthroscopy, knee, surgical; drilling for osteochondritis dissecans with bone grafting, with or without internal fixation (including dbridement of base of lesion) . Medial = 29875. The guideline states, "CPT code 29876 may be reported for a medically reasonable and necessary synovectomy with another arthroscopic knee procedure on the ipsilateral knee if the synovectomy is performed in two compartments on which another arthroscopic procedure is not performed." En Pointe CPT code and description 29881 - Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment (s), when performed average fee amount - $540 - $600 29871 - ARTHROSCOPY KNEE INFECTION LAVAGE & DRAINAGE CPT 29875 - Arthroscopy, knee, surgical; for infection, lavage and drainage synovectomy, limited. Articles Arthroscopy Coding for Major Joints - Shoulder Michael R. Marks, MD, MBA AAOS Now - March 2018 An accurate understanding of coding rules increases likelihood of receiving appropriate paymentCorrectly reporting and billing for arthroscopy services is often confusing. CPT code 29875 should not be reported with another arthroscopic knee procedure on the ipsilateral knee. AAOS: Coding Knee Arthroscopies Author: Mary LeGrand, RN, MA, CCS-P, CPC Coding knee arthroscopies can be Knee arthroscopy is the most commonly . Arthrotomy, elbow, for infection, with exploration, drainage or removal of foreign body (24000) Arthrotomy of the elbow, with capsular excision for capsular release separate procedure (24006) Arthrotomy, elbow; with synovial biopsy only (24100) Arthrotomy, elbow; with joint exploration, with or without biopsy . . Icing is important for the first 5-7 days post-op. 29882 cpt code description. View AAOS Coding Knee Arthroscopies.pdf from CODING 001 at Coding certification .org. . The lateral synovectomy, CPT 29875, is inclusive in the lateral meniscectomy procedure reported with CPT 29881. You can code procedures performed in each compartment separately with 2 notable exceptions: major synovectomy (29876) and meniscus repair (29882). . Choose Procedure or Surgery The rules for surgery in a "separate compartment" do not apply. The rules for surgery in a "separate compartment" do not apply. Access to this feature is available in the following products: Jul-Sep 2012;2(3):e53. A HCPCS/CPT code shall be reported only if all services described by the code are performed. 29876 - Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral) Note: Involves resection of synovium and/or plica from two or more compartment. Coding for Arthroscopic Knee Surgery in ICD-10-PCS In ICD-10-PCS, arthroscopy goes to the root operation "inspection," which is defined as . A third line (C) is drawn along the lateral patellar facet. 29875 Arthroscopy, knee, surgical; synovectomy, limited (separate procedure) CPT defines limited synovectomy as a "separate procedure.". Start studying CPT Coding Manual -- Coding Quiz. Some common arthroscopic knee surgeries include the following: . CPT Code: 29882, 29875. Lipoma Arborescens of the Knee Treated with Arthroscopic Synovectomy: A Case Report and Review of the Literature JBJS Case Connect. Another area of high usage is a limited synovectomy (CPT code 29875). The incidence of CPT code 29999 (unlisted procedure, arthroscopy) increased by 76.6% from 2007 to 2014 (P < 0.001), although the majority of this increase was seen prior to 2011, . Synovectomy 11) Lysis of adhesions for arthrofibrosis of the knee secondary to trauma/injury 12) Debridement with or without chondroplasty for mild to moderate cartilage wear Sabemos que sus maquinas son muy importantes, por eso ustedes son nuestra prioridad. Arthrotomy / synovectomy. Arthroscopy to treat the diagnosis of osteoarthritis of the knee. 29836 Arthroscopy, elbow, surgical; synovectomy, complete 29837 Arthroscopy, elbow, surgical; debridement, limited 29838 Arthroscopy, elbow, surgical; debridement, extensive Humerus/Elbow - Arthroscopy CPT Code Defined Ctgy Description 24065 Biopsy, soft tissue of upper arm or elbow area; superficial 24066 Biopsy, soft tissue of upper arm or . chronic knee pain for 3 years (focal synovial issue which nobody could find) from an overuse injury 2017; operation to fix torn hip labrum and partial synovectomy in knee in Sept 2020; 7 weeks post-op, knee issue grows back (potentially way over active physio/blood thinners) but prior to this good recovery What is the CPT code for the procedure, operative . While the post-op dressing is in place, icing should be done continuously. CPT has assigned the "separate procedure" designation to 29875 Arthroscopy, two arthroscopy, *29886 . Create. 29876 - Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral) . AAOS Bulletin - April, 2005 I know 27427 cannot be coded with 29888 and 29889 per cpt code book. Description . Knee arthroscopy is a surgical procedure where a fiber-optic camera is put into the knee joint to look at . 29819, 29834, 29861, 29874, 29894, 29904) may be reported only when the loose body (ies . Evaluation of the cruciate ligaments is also reviewed. CPT codes 29866 through 29887 are used to report a knee arthroscopy. Report it when it's the only arthroscopic procedure performed on that knee. CPT Code Set. The CPT code that should be reported is 29881. Only the medial compartment will have a final synovectomy reporting of CPT 29875. Diagnostic arthroscopy of the left knee with synovial biopsy.[29870-LT. Arthrotomy / synovectomy CPT Codes. Treatment of meniscal tears is the most common reason for knee arthroscopy, with approximately 700,000 arthroscopic partial meniscectomies performed annually. The lateral synovectomy, CPT 29875, is inclusive in the lateral meniscectomy procedure reported with CPT 29881. Additionally, arthroscopic repair of a superior labral anterior posterior (SLAP) lesion (29807) may also be billed with the loose body code (29819-59). 29836 Arthroscopy, elbow, surgical; synovectomy, complete 29837 Arthroscopy, elbow, surgical; debridement, limited 29838 Arthroscopy, elbow, surgical; debridement, extensive Humerus/Elbow - Arthroscopy CPT Code Defined Ctgy Description 24065 Biopsy, soft tissue of upper arm or elbow area; superficial 24066 Biopsy, soft tissue of upper arm or . doi: 10.2106/JBJS.CC.K.00115. However, this can be misleading. 29881LT Arthroscopy, knee, surgical; with meniscectomy (medial or lateral, including any meniscal shaving), left knee. Compartments are not significant for reporting this CPT code. Therefore, 29875 should be reported when it is the only arthroscopic procedure performed on that knee. Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments (eg, medial or lateral) HCPCS code G0289, Arthroscopy, knee, surgical, for removal of loose body . This procedure is universally considered inclusive to any more . Rationale: CPT code 29875 is a limited synovectomy (separate procedure) and can't be reported if any other arthroscopic knee procedure is performed on the same knee in the same session. 8016: 29875: synovectomy, limited (e.g. Additionally, arthroscopic repair of a superior labral anterior posterior (SLAP) lesion (29807) may also be billed with the loose body code (29819-59). acl hamstring tendon autograft reconstruction protocol the intent of this protocol is to provide the . 29877-59Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty) The surgeon appends modifier 59 to CPT code 29877 to indicate that a distinct separate procedure was performed in a different anatomic location (chondroplasty in the medial and patellofemoral compartments). The CPT code that should be reported is 29881. March 23, 2022. professional competency areas for student affairs practitioners. Arthrotomy / synovectomy CPT Codes. Although chondroplasty of the knee (also known as notchplasty . Synovectomy (limited [e.g., plica or shelf resection], as a stand-alone procedure, or a major procedure with 2 or more compartments [e.g., medial or lateral]) is considered CPT has two codes for synovectomy: 29875 for one compartment and 29876 for two or more compartments. CMM-312: Knee Surgery-Arthroscopic and Open Procedures Version 1.0 Effective July 1, 2021 . Arthrotomy, elbow; with synovial biopsy only (24100) Excision, olecranon bursa (24105) Excision, lesion of tendon sheath, forearm and/or wrist (25110) Home Browse. 29875 Arthroscopy, knee, surgical; synovectomy, limited (e.g., plica or shelf resection) (separate . 6 . Hip arthroscopy, synovectomy . A limited synovectomy would be considered an integral component of any arthroscopic procedure done on the same knee. cpt code 29876: Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments (eg, medial or lateral) A synovectomy to "clean up" a joint on which another more extensive procedure is performed is not separately reportable. 27347 - Excision of lesion of meniscus or capsule (eg, cyst, ganglion), knee. CPT code and description 29881 - Arthroscopy, plica or shelf resection) (separate procedure), surgical, OA of knee a, surgical, The codes provided are from the 2014 edition of CPT Plus and 2014 ICD. 29860. Coding Cautions. Capsulorrhaphy or reconstruction, wrist, any method eg, capsulodesis, ligament repair, tendon transfer or graft) (includes synovectomy, capsulectomy, and open reduction) for carpal instability (25320) Synovectomy tendon sheath, radical tenosynovectomy, flexor, palm or finger, single, each digit (26145) The operation instruments included 30 and 70 arthroscopy, planing knife series, arthroscopic special electric knife and Arthrocare 2000 plasma operation system. Meniscectomy (80.6), excision of meniscus of knee Synovectomy (80.76), complete or partial resection of synovial membrane. Plica or shelf resection) (separate procedure) 8076: 29876: synovectomy, major, two or more compartments (e.g . View CODING-ARTHROSCOPIC-KNEE-PROCEDURES.pdf from NUR 4633 at Florida SouthWestern State College, Lee. Synovectomy refers . "separate procedure" CPT code to indicate that it qualifies as a separately reportable service. any meniscal shaving) or CPT code 29881, Arthroscopy, knee, surgical; with meniscectomy (medial or lateral, including any meniscal shaving)if performed in a separate compartment. CODING ARTHROSCOPIC KNEE PROCEDURES Knee Anatomy: The medical compartment includes: Medial . The CPT codes that should be reported are 29876 and 29881. Other indications include assistance for cruciate ligament reconstruction, osteochondral lesions, removal of loose bodies, synovectomy, and septic arthritis. Sequencing should be the most significant procedure first (usually highest CPT code number) with the exception of: 29880/29881 29882/29883 . 29876 arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments (eg, medial or lateral) Synovectomy codes in both the shoulder and the knee are governed by the same guidance. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Medial = 29875 Lateral = 29875 + 29881 = 29881 (CPT 29875 bundles into 29881) Patellofemoral = n/a ACL Hamstring Tendon Autograft Reconstruction Protocol. Left knee arthroscopy and major synovectomy. The edit has a modifier indicator of "1," which means you may bypass the edit in appropriate clinical circumstances. . CPT code 29876 is defined as "Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments (eg, medial or lateral)." . Lateral = 29875 + 29881 = 29881 (CPT 29875 bundles into 29881) Patellofemoral = n/a. Only the medial compartment will have a final synovectomy reporting of CPT 29875. C. CPT Code for Arthroscopic Arthrolysis of Knee: 29884 - Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure) . The correct codes for the example listed above are . Authors Andrzej Jurkiewicz 1 , Przemysaw Krakowski 1 , Agnieszka Korolczuk 2 Affiliations 1 Orthopaedic . CPT Code: CPT Description: ICD -9 Procedure: 29871: Arthroscopy, knee, surgical; for infection, lavage and drainage . The code 29876 can be assigned in addition to 29881. Knee Surg Sports Traumatol Arthrosc. cpt code 29870 arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure) 29871 arthroscopy, knee, surgical; for infection, lavage and drainage . Provider can bill 29881 and 29876 . And if no, please. Coding This policy is not intended to address arthroscopy for other medically necessary indications, such as in the presence of infection, for the removal of loose or foreign . Lateral = 29875 + 29881 = 29881 (CPT 29875 bundles into 29881) Patellofemoral = n/a. Synovectomy codes in both the shoulder and the knee are governed by the same guidance. The correct codes for the example listed above are . CPT Code: 29876Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral) . As an example, the first-quarter 2021 Medicare NCCI PTP edits include the edit pair 29827 Arthroscopy, shoulder, surgical; with rotator cuff repair and 29820 Arthroscopy, shoulder, surgical; synovectomy, partial. KNEE ARTHROSCOPY Procedures and Related CPT and ICD-9 Procedure Codes. Rationale: CPT code 29875 is a limited synovectomy (separate procedure) and can't be reported if any other arthroscopic knee procedure is performed on the same knee in the same session. >CPT Code 29820 - Arthroscopy, shoulder, surgical; synovectomy, partial. of a loose or foreign body with a menisectomy code if the body was removed from a different compartment of the same knee. Diagnostic hip arthroscopy. One area of confusion for arthroscopic knee, shoulder, and hip coding is modifier usage. Once the dressing is removed on the first or second day, ice is applied for 20-minute periods 3-4 times per day. should never be reported for a major synovectomy with CPT code 29880 (knee arthroscopy, medial AND lateral meniscectomy) on the ipsilateral knee since knee arthroscopic procedures other than synovectomy are . Coding Knee Arthroscopy with Precision. Some coders will be tempted to assign code 29877, which describes arthroscopy with debridement/shaving of articular cartilage (chondroplasty). Mpfl Rekonstruktion Knie Cpt Code Cpt Code For Arthroscopic Mpfl Reconstruction - 08/2020 any meniscal shaving) or CPT code 29881, Arthroscopy, knee, surgical; with meniscectomy (medial or lateral, including any meniscal shaving)if performed in a separate compartment. Placement of catheter into muscle for subsequent interstitial radioelement . HCPCS code G0289 may be reported in addition to CPT code 29880, Arthroscopy, knee, surgical; with meniscectomy (media AND lateral, including any meniscal shaving) or CPT code 29881, Arthroscopy, knee, surgical; with meniscectomy (medial or lateral, including any meniscal shaving)if performed in a separate compartment . 29875 Arthroscopy, knee, surgical; synovectomy, limited (separate procedure) CPT defines limited synovectomy as a "separate procedure." Therefore, 29875 should be reported when it is the only arthroscopic procedure performed on that knee. 29875 Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (separate procedure) Limited synovectomy is defined in CPT as a "separate procedure." As such, do not report 29875 with another arthroscopic procedure in the same knee. CPT code 29875 limited synovectomy can be reported only if it is the only procedure performed. reported for a major synovectomy with CPT code 29880 (knee arthroscopy . 5Hip, Knee and Shoulder urgery -Utilization Review Matrix - 2021 Distal Clavicle Excision (Mumford procedure): 29824 Subacromial Decompression: 29826 Shoulder Rotator Cuff Repair 29827 23410, 23412, 23420, 29827 Claviculectomy: 23120, 23125 Acromioplasty: 23130 Coracoacromial ligament release: You must bundle these even if they're performed in different compartments. Using an axial CT cut of the knee, a line (A) is drawn connecting the posterior femoral condyles. 27335 - Arthrotomy, with synovectomy, knee; anterior AND posterior including popliteal area. The most commonly used modifiers for arthroscopy are 51 (multiple procedures) and 59 (distinct procedural service). 29877 - Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty) 29879 . Becker's Healthcare: Hospital; ASC; Spine; Clinical; Health IT; CFO; Dental + DSO; Payer; Career Center 1.800.417.2035 . . Typical CPT Codes 27415 - Osteochondral allograft, knee, open 27599 - Unlisted procedure, femur or knee 27899 - Unlisted procedure, leg or ankle 29867 - Arthroscopy, knee, surgical; osteochondral allograft (ex: mosaicplasty) Typical HCPCS Codes C1762 - Billing code for allograft Example: Challenge meniscal . This procedure . Use the -59 modifier (distinct procedural service) for each subsequent . . Example: 29876 - Arthroscopy, medical compartment and suprapatellar pouch synovectomy G0289 - Arthroscopy, knee, surgical, . Medial = 29875. If lines B and C converge laterally, this is radiographic confirmation of an excessively tight . Last month, AAOS Now reviewed the knee arthroscopy codes and outlined the appropriate use of modifiers. Prominence Health Plan: Joint Surgery CPT Code List: Updated: 6/12/2018 Category CPT Code CPT Code Description Joint Surgery Mgmt 23466: Capsulorrhaphy, glenohumeral joint, any type multi-directional instability . Arthroscope was inserted and thickened synovial tissue was excised from the medial, lateral, and femoropopliteal compartments. (g py gSurgical knee arthroscopy for debridement/shaving of articular cartilage) should not be reported with other knee arthroscopy codes (29866-29889). (Surgical knee arthroscopy with meniscectomy including debridement/shaving of articular cartilage of same or separate compartment(s)) include debridement/shaving of articular cartilage of any compartment . CPT Code Description OPPS Status Indicator Ambulatory Payment Classification ASC Payment Indicator Arthroplasty 27440 Arthroplasty, knee, tibial plateau J1 5115 J8 27441 Arthroplasty, knee, tibial plateau; with debridement and partial synovectomy J1 5115 G2 27442 Arthroplasty, femoral condyles or tibial plateau(s), knee J1 5115 J8 27443 Compartments are Page 1/5 In the surgery guidelines of CPT, the instructions state that codes designated as "separate procedure" should not be reported in addition to the code for the total procedure or service of which it is considered an integral component. Search. CPT code 29820 should not be reported and modifier 59 should not be used if both procedures are performed on the same shoulder during the same operative session because the shoulder joint is a single anatomic structure. Mastery of these techniques is critical for the treatment of the most common pathology encountered during knee arthroscopy. When that occurs, coding 29827 (arthroscopic rotator cuff repair) with 29819-59 is permissible. This. Synovectomy CPT Codes. Knee Arthroscopy Coding. Arthrotomy, elbow, for infection, with exploration, drainage or removal of foreign body (24000) Arthrotomy of the elbow, with capsular excision for capsular release separate procedure (24006) Arthrotomy, elbow; with synovial biopsy only (24100) Arthrotomy, elbow; with joint exploration, with or without biopsy . Carpal Tunnel, Trigger Fingers deQ. A surgical arthroscopy may be performed to treat diseased or damaged structures of the knee joint, such as a torn meniscus, damaged patella and inflamed or damaged synovium. The lateral synovectomy, CPT 29875, is inclusive in the lateral meniscectomy procedure reported with CPT 29881. Surgery Pricing. One of the biggest challenges in coding knee arthroscopies is determining whether to select CPT 29875 (arthroscopic synovectomy, limited,) or CPT 29876. The billed procedure codes 29877 and 29880 are reported together when performed in separate compartments of the knee during the same session. With 2 exceptions, (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) shall not be reported with other knee arthroscopy codes (29866-29889). 27334 - CPT Code in category: Arthrotomy, with synovectomy, knee.