Orthopedic Coding Alert

Question: Can 29879 be reported with 29877 if the two procedures are performed in different compartments of the knee?

Hawaii Subscriber

 
Answer: There are several reasons not to report these two codes together. The Complete Global Service Data for Orthopaedic Surgery guide of the American Academy of Orthopaedic Surgeons states that 29879 (Arthroscopy, knee, surgical; abrasion arthroplasty [includes chondroplasty where necessary] or multiple drilling or microfracture]) includes articular shaving, debridement, and/or chondroplasty (e.g., 29877). 
 
Compare that to the global service package for 29881 ( with meniscectomy [medial OR lateral, including any meniscal shaving]) and you will see that it includes articular shaving, debridement, and/or chondroplasty in the same compartment (e.g., 29877, 29879). This suggests that compartments are not a factor when an abrasion arthroplasty is performed and that a chondroplasty (29877, debridement/shaving of articular cartilage [chondroplasty]) would always be considered a component of that procedure. In addition, the guidelines at the beginning of the global service data books offer very specific recommendations with regard to arthroscopic chondroplasty and abrasion arthroplasty: Chondroplasty procedure(s) can only be coded one time per joint, no matter how many compartments are debrided.