By that logic, the AMA should support reporting 29876 with 29881 (- with meniscectomy [medial OR lateral, including any meniscal shaving]) when the surgeon performs them at the same session. Consider this example: A patient has a medial meniscectomy (29881) along with both medial and lateral synovectomies. Click to see full answer.
What is the CPT code for lateral meniscus repair?
May 10, 2020 · Can CPT code 29876 and 29881 be billed together? By that logic, the AMA should support reporting 29876 with 29881 (- with meniscectomy [medial OR lateral, including any meniscal shaving]) when the surgeon performs them at the same session.
How to look up CPT codes for free?
On the disputed date of service, the requestor billed CPT codes 29881-LT and 29875-LT-59. Per CCI edits, CPT code 29875 is a component of CPT code 29881; however, a modifier is allowed to ifferentiate the service. A review of the requestor’s billing finds that the requestor appended modifier “59-Distinct Procedural Service” to CPT code 29875.
What is the CPT code for left knee pain?
Feb 08, 2022 · 29881 (medial) and 29873-59 (lateral)—–note different compartments, different modifiers! You can also bill the 29879-51 also not in the CCI edits. Can 29880 and 29876 be billed together? 29876 is a column 2 code to 29880. According to the NCCI manual, you cannot bill 29876 with 29880 due to the three-compartment rule.
What is the CPT code for knee surgery?
CPT Codes: 29876 Arthroscopic extensive synovectomy 29876 for the extensive synovectomy is the only code reported. G0289 for the loose body is NOT CODED because the synovectomy was done in the same compartment as the loose body and therefore it was not in a separate compartment and is not to be coded. Scenario 2 Procedures performed: 1.
Can you bill CPT codes 29881 and 29882 be billed together?
Can I bill for a medial meniscus repair and a lateral meniscus meniscectomy done on the same knee? I see CMS has an NCCI edit between the two codes, 29881 and 29882. Answer: Yes, you may report both codes and append modifier 59 to indicate the procedures were performed on different anatomic sites.Mar 5, 2020
Can 29880 and 29876 be billed together?
partial synovectomy involving the notch and patellofemoral region.” Per NCCI Policy Manual, Chapter IV, Section (E)(8), code 29876 may not be billed with code 29880 when performed on the same knee. Based upon the operative report the procedures were performed on the left knee.Jul 20, 2018
Can you bill 29881 and G0289 together?
Since CPT codes 29880 and 29881 (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, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for ...May 17, 2017
What is procedure code 29876?
CPT code 29876 describes a major synovectomy and may be reported in two or more compartments when performed. This is where the coding becomes a bit confusing. Surgeons commonly perform a synovectomy in addition to other procedures to “clean up” the joint while performing more extensive surgery.Jan 1, 2013
Can 29881 and 29875 be billed together?
Both procedures code 29881 and 29875 were performed on the same anatomically related region (knee); therefore, 29875 cannot be reported with 29881 and the use of modifier 59 is not supported. As a result, reimbursement is not recommended.
What is the difference between CPT code 29880 and 29881?
By definition, 29880 reports meniscectomy in both the medial and lateral compartments, while 29881 defines a meniscectomy in either the medial or lateral compartment.Feb 1, 2016
Does CPT 29881 need a modifier?
Modifier 59 is appended to CPT code 29881 to indicate a distinct separate procedure in a different anatomic location (lateral repair vs medial meniscectomy).May 1, 2012
Can CPT codes 29876 and 29877 be billed together?
CPT codes 29874, 29875, 29876 or 29877 will not be considered for additional reimbursement when performed on the same date as, or in conjunction with, one of the primary procedure codes listed above even when appended with Modifier 59.Dec 29, 2014
Can 29888 and 27427 be billed together?
Therefore, codes 27427 and 29888 may be reported for the same operative session. Modifier 51, Multiple Procedures, should be appended to the...
What is the CPT code 29881?
CPT® 29881, Under Endoscopy/Arthroscopy Procedures on the Musculoskeletal System. The Current Procedural Terminology (CPT®) code 29881 as maintained by American Medical Association, is a medical procedural code under the range - Endoscopy/Arthroscopy Procedures on the Musculoskeletal System.
What is 29884 arthroscopy?
29884 Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)#N#Because it’s a “separate procedure,” do not report arthroscopic lysis of adhesions with any other arthroscopic procedure in the same knee, whether for Medicare or non-Medicare claims.
What is the CPT?
The American Medical Association’s (AMA) CPT® is a set of codes, descriptions, and guidelines intended to define procedures and services. Since 1966, it has been the standard for reporting physician-performed services.
What is NCCI code?
NCCI includes a combination of narrative guidelines and code-specific, procedure-to-procedure edits. The edits indicate that two services are never paid together using a designator of “0” and that two services could be paid together if appropriate criteria are met using a designator of “1.”.
Is 29877 a primary code?
Likewise, the GSD guidelines state 29877 is separately reportable with other procedures when performed in a separate compartment where no other surgical procedure is performed, and when it’s not included in the primary code by definition (29880 and 29881 do not meet this requirement).
What is 29880 coded for?
29880 Arthroscopy medial and lateral meniscectomy G0289 for the Arthroscopic removal of a loose body in a separate compartment 29880 is coded for the medial AND lateral meniscectomy Since the loose body removal was done in a separate compartment (patellofemoral), the G0289 is coded.
What is the HCPCS code for knee surgery?
An important HCPCS code is G0289, Arthroscopy, knee, surgical, for removal of loose body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee. This code is used for Medicare to report the procedure in that description, when performed in a separate compartment of the knee during the same operative session. It is not appropriate to use code 29877 even with a modifier.
What type of cartilage is used in the knee?
Slippery and flexible, hyaline (articular) cartilage within the knee joint allows, has less friction than two pieces of glass placed together. This allows the joint to move with minimal friction in a healthy knee. There are two primary types of cartilage in the knee:
What is the code for a meniscectomy?
“From a CPT® coding perspective, if debridement or shaving of articular cartilage and meniscectomy are performed in the same compartment of the knee, then only code 29881, Arthroscopy, knee, surgical; with meniscectomy (medial or lateral, including any meniscal shaving), should be reported. However, if debridement or shaving of articular cartilage is performed in one compartment of the knee and a meniscectomy is performed in a different compartment of the knee, then codes 29877, Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty), and 29881 should be reported.”
What is ACL repair?
29888 – ACL Repair G0289 - Arthroscopy, knee, surgical, for removal of loose body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee
Is G0289 a synovectomy?
29876 for the extensive synovectomy is the only code reported. G0289 for the loose body is NOT CODED because the synovectomy was done in the same compartment as the loose body and therefore it was not in a separate compartment and is not to be coded.
What is a 29880?
Meniscectomy(29880 and 29881)involves surgery to remove of all or part of a torn meniscus. 29880Arthroscopy, knee, surgical; with meniscectomy (medial and lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed.
What is modifier 59?
Modifier 59 is not used for Medicare claims. Medicare assumes that G0289 represents the arthroscopic removal of a loose body or foreign body in a different compartment. Modifier 59 may be applied when reporting 29877 to private payers to indicate the separate compartment rule is met. Removal of Loose or Foreign Bodies.
What is knee arthroscopy?
Knee arthroscopy is an effective and frequently used tool for diagnosing knee conditions such as meniscus tears and cartilage wear. Orthopedic surgeons and their medical coding serviceproviders need to understand the different types of CPT codes involved as well as Medicare’s National Correct Coding Initiative (NCCI) guidelines, ...
What is the purpose of a fiber optic endoscope?
Knee arthroscopy involves using a fiber optic endoscope to visualize the joint space of the knee. This allows the surgeon to perform arthroscopic surgery using instruments inserted through small incisions, rather than having to perform an open procedure.
What does CPT code 29999 mean?
CPT 29999, Under Endoscopy/Arthroscopy Procedures on the Musculoskeletal System. The Current Procedural Terminology (CPT) code 29999 as maintained by American Medical Association, is a medical procedural code under the range - Endoscopy/Arthroscopy Procedures on the Musculoskeletal System.
Can CPT 29875 and 29877 be billed together?
Encoder pro says you can't bill 29875 and 29877 together under any circumstances.
What is CPT code g0289?
G0289 is a valid 2020 HCPCS code for Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee or just “Arthro, loose body + chondro” for short, used in
What is procedure code 29888?
Anterior cruciate ligament reconstruction (ACL reconstruction) is a surgical tissue graft replacement of the anterior cruciate ligament, located in the knee, to restore its function after anterior cruciate ligament injury. The surgery is performed arthroscopically.
What is a meniscectomy?
Surgery Overview. Meniscectomy is the surgical removal of all or part of a torn meniscus. A meniscus tear is a common knee joint injury. Surgeons who perform meniscectomies (orthopedic surgeons) will make surgical decisions based on the meniscus's ability to heal as well as your age, health, and activity level.
Does CPT code 29888 include graft?
Harvesting and inserting the graft is included in code 29888, regardless of whether the graft is a patellar tendon or a hamstring tendon. Some surgeons are now harvesting bone from the proximal tibia (e.g., from the bone tunnel) and grafting it to the patellar bone defect.
What is arthroscopy for?
Arthroscopy is a surgical procedure orthopaedic surgeons use to visualize, diagnose, and treat problems inside a joint. The word arthroscopy comes from two Greek words, "arthro" (joint) and "skopein" (to look). The term literally means "to look within the joint."
Meniscectomy and Meniscal Repairs
Removal of Loose Or Foreign Bodies
- 29874 Arthroscopy, knee, surgical; for removal of loose body or foreign body (eg, osteochondritis dissecans fragmentation, chondral fragmentation) As is true when reporting chondroplasty, there are differences between CPT® and Medicare reporting requirements when reporting arthroscopic removal of loose or foreign bodies. Although the CPT® definition does not specify as such, the …
Lateral/Retinacular Release
- 29873 Arthroscopy, knee, surgical; with lateral release NCCI edits pair 29873 with 29874 and 29877 with a “0” modifier indicator because Medicare requires G0289 to describe either the chondroplasty or loose/foreign body removal when performed with 29873, and to meet the separate compartment criterion. Under CPT® rules, chondroplasty must be performed in a sepa…
Lysis of Adhesions
- 29884 Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure) Because it’s a “separate procedure,” do not report arthroscopic lysis of adhesions with any other arthroscopic procedure in the same knee, whether for Medicare or non-Medicare claims.
CPT®, GSD, and NCCI Histories
- The American Medical Association’s (AMA) CPT® is a set of codes, descriptions, and guidelines intended to define procedures and services. Since 1966, it has been the standard for reporting physician-performed services. The AAOS developed and maintains a supplemental set of coding guidelines for its members. Introduced in 1991 and called the Complete Global Service Data for …