# 29876 with 29888



## coders_rock! (Oct 23, 2012)

Does anyone know if and under what guidelines can these be reported together.

29876 is being denied to 29888. CCI edit is allowing a modifier with 29876 but I don't want to add it if it's not appropriate. 

Please help, thanks!


----------



## scooter1 (Oct 25, 2012)

Here are excerpts from some articles. I don't know if it helps . . . 


Anthem Central Region does not bundle 29874, 29876 or 29877 with 29888. Based on the Complete Global
Service Data for Orthopaedic Surgery, codes 29874 and 29877 are listed under services that are not
included in the global service package of procedure 29888. Code 29876 is not listed as being included or
not included under code 29888. Therefore, if 29874, 29876 or 29877 is submitted with 29888--all will
reimburse separately


According to AAOS guidelines, when a physician performs a multiple compartment synovectomy in the same compartment where another procedure from which the 29875 code is unbundled, the synovectomy is included in the other procedure and you may not bill for it separately using code 29876.  
However, when a physician performs a synovectomy in another compartment, and this was the only procedure he or she performed in that compartment, report code 29875 with modifier -59.  In other words, only report code 29876 when a physician performs a multiple compartment synovectomy in compartments where another procedure is not performed


Synovectomy Procedures 
For coding Synovectomy procedures, the following applies: 
1. The 29875 code for a Limited Synovectomy includes the partial resection of synovium or plica from one knee compartment. Code 29875 is considered a “Separate Procedure”, thus if this Limited Synovectomy is performed in the same compartment with another procedure, it is not billable. If the procedure is performed in a separate compartment, is a separate procedure, is carried out independently, or is considered unrelated (different compartment) from the other procedure from which the 29875 code is Unbundled, it could be billed with a –59 Modifier. 
2. The 29876 code for a Major Synovectomy involves removal of the synovium and plicae from 2 or more knee compartments. 
3. If both a Limited and Major Synovectomy procedure are performed, the 29875 and 29876 codes should not be billed together. The 29876 code would be all-inclusive, and should be the only code billed. 
4. If a multiple compartment Synovectomy is performed in the same compartment where another procedure from which the 29875 code is Unbundled, the Synovectomy would be included in the other procedure and would not be separately-billable using the 29876 code. However, if the Synovectomy was performed in another compartment and was the only procedure performed in that compartment, it would be billable with the 29875 code using the -59 Modifier


----------

