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One of the biggest challenges in coding knee arthroscopies is determining whether to select CPT 29875 (arthroscopic synovectomy, limited,) or CPT 29876 (arthroscopic synovectomy, major, two or more compartments).
Let's say the physician performs an arthroscopic lateral meniscectomy and an arthroscopic two-compartmental synovectomy of the medial and lateral compartments of the right knee. It is incorrect to report an arthroscopic two-compartmental synovectomy, CPT 29876 in this case. The lateral synovectomy, CPT 29875, is inclusive in the lateral meniscectomy procedure reported with CPT 29881. Only the medial compartment will have a final synovectomy reporting of CPT 29875.
- Medial = 29875
- Lateral = 29875 + 29881 = 29881 (CPT 29875 bundles into 29881)
- Patellofemoral = n/a
The correct codes for the example listed above are 29881-RT; 29875-59 RT.
Let's say the physician performs an arthroscopic lateral meniscectomy and an arthroscopic two-compartmental synovectomy of the medial and patellofemoral compartments of the right knee. Because the medial and patellofemoral synovectomies are distinct from the lateral location, an arthroscopic two-compartmental synovectomy, CPT 29876 is supported.
- Medial = 29875
- Lateral = 29881
- Patellofemoral = 29875
The correct codes for the example listed above are 29881-RT; 29876-RT.
Coding tip: When reading the operative report description, follow the surgeon as he describes the procedures performed within each of the three compartments. Look at each compartment, then determine the overall code(s) for each individual compartment.
Cristina Bentin can be reached at cristina@ccmpro.com. Learn more about Coding Compliance Management.
The information provided should be utilized for educational purposes only. Please consult with your billing and coding expert. Facilities are ultimately responsible for verifying the reporting policies of individual commercial and MAC/FI carriers prior to claim submissions.