Orthopedic Coding Alert

Reader Question:

Select One Code for Arthroscopy in Each Knee Compartment

Published on Tue Nov 15, 2011

Question: Our surgeon did an arthroscopic medial meniscus repair and lateral meniscectomy. The scrub on the billing service we use indicates that I need a modifier on 29882 (Arthroscopy, knee, surgical; with meniscus repair ([medial OR lateral]) because it is a component of 29881 (Arthroscopy, knee, surgical; with meniscectomy ([medial OR lateral, including any meniscal shaving)]), however, 29882 is higher RVU. How do we report this? Is it not incorrect to have a 59 (Distinct Procedural Service:...) modifier on the primary procedure?

Florida Subscriber

Answer: If your payer follows Medicare NCCI guidelines, you will need modifier 59 on code 29882 as this is considered "mutually exclusive" to code 29881. Only one code is allowed for arthroscopy in each compartment. You cannot report two codes in the medial compartment. Also 29881 and 29882 are bundled together; you can't do both together. In this case, since the surgeon is doing a meniscus repair, you should report 29882.

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