Orthopedic Coding Alert

The "American Academy of Orthopedic Surgeons (AAOS) still advocates you report code 29874 in addition to 29881 or 29880 in the following situation: Loose (nonmeniscal) or foreign bodies greater than 5 mm AND/OR removed through a separate incision", advises Kristi Stumpf, MCS-P, CPC, COSC, ACS-OR, owner, Precision Auditing and Coding, senior orthopedic coder & auditor, The Coding Network, Washington. "Note that separate compartment is no longer listed as criteria in the AAOS GSDG. Separate compartment is still an indicator per NCCI guidelines."

Stumpf shares an excerpt from the NCCI Policy Manual for 2012 regarding HCPCS code G0289 (Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage [chrondroplasty] at the time of other surgical knee arthroscopy in a different compartment of the same knee) which describes arthroscopy foreign body removal and chondroplasty at the time of another arthroscopy in another compartment in same knee. "Note the differences in reporting guidelines between Federal and Private Payor (AAOS-GSDG) guidelines."

From NCCI Policy Manual 2012, Chapter IV Musculoskeletal System:

Coding tip: Review the procedure note carefully to clearly understand how the loose/foreign body was removed. "Be aware that loose bodies that are simply washed out via lavage do not meet separate reporting guidelines. The work value of formal loose body removal must be more than simply washing out through the portal during lavage of the knee to support separate reporting," says Stumpf.