Orthopedic Coding Alert
Know Codes for Other Diagnostic Knee Procedures
MRI, X-ray might replace knee arthroscopy in certain situations. There’s more than one way to skin a cat, as the old (and confusing) saying goes. There’s also more than one way to diagnose a knee injury. While the earlier story dealt with diagnostic knee arthroscopies, these aren’t the only way that your provider might examine a knee for signs of injury or underlying issues. Check out what codes you might need to use for your provider’s services when they diagnose a knee injury. X-Rays Less Invasive According to Heidi Stout, CPC, COSC, with Coder on Call, Inc., in Milltown, New Jersey, magnetic resonance imaging (MRI) has become a useful tool when diagnosing knee injuries. The use of MRIs — or X-rays that might also help in the diagnosis of a knee injury — means that 29870 claims might be getting rarer for some providers. MRIs and X-rays help providers “get a fairly comprehensive picture of a patient’s knee pathology, greatly reducing the need for a diagnostic scope as a solo procedure,” Stout explains. They’re not foolproof, however, and your provider might always fall back on an arthroscopy to pinpoint the problem. Some of the MRI codes you might employ for your provider’s diagnostic knee services include: The provider might also use X-rays or other imaging studies instead of opting for the more invasive arthroscopy. Some of the x-rays that the provider might perform in lieu of 29870 include: Note: This is not a comprehensive list of methods a provider would use to diagnose a knee injury; always code according to the provider’s notes, choosing the most appropriate code for the situation. 29870 Might Be Last Option That’s not to suggest that provider don’t still use 29870 to diagnose knee injuries. In fact, if the MRI and/or X-ray prove inconclusive, the surgeon might opt for a diagnostic arthroscopy to do a final check for injury. So, it’s possible that you might see a claim with both an MRI/X-ray and a diagnostic knee arthroscopy. You’ll always code based on encounter specifics, but there’s no restriction on coding for both the MRI/X-ray and the arthroscopy. If you have any questions about this code combination, check with the provider or the payer before filing the claim.
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