Orthopedic Coding Alert

Question: Is it ever appropriate to bill for a 29875 with 29877 and 29874 ?

I know these are normally bundled, but in this particular surgery, the physician did a lot of extra work.

Arkansas Subscriber

Answer: It is appropriate to report a CPT code with separate procedure designation with other codes to describe a single surgical event only when the separate procedure is performed at a separate anatomic site. For example, it is acceptable to report 29875 (arthroscopy, knee, surgical; synovectomy, limited [e.g., plica or shelf resection] [separate procedure]) with 28285 (correction, hammertoe [e.g., interphalangeal fusion, partial or total phalangectomy]) if the patient had an arthroscopic plica resection done at the same time as a hammertoe correction.

However, in a situation such as you describe, when the plica resection is part of a more comprehensive arthroscopic procedure, it should not be reported. The good news is that according to the American Association of Orthopedic Surgeons (AAOS) Complete Global Service Data for Orthopedic Surgery, 29874 (arthroscopy, knee, surgical; for removal of loose body or foreign body [e.g., osteochondritis dissecans fragmentation, chronrdal fragmentation]) can be billed in conjunction with 29877 (arthroscopy, knee, surgical; debridement/shaving of articular cartilage [chondroplasty]).