Orthopedic Coding Alert

Question: Our provider performed an arthroscopy with iliopsoas lengthening. We cannot find a CPT® code that lines up exactly with this procedure, so what can we report?

Arkansas Subscriber

Answer: Unfortunately, there isn't a code specifically for arthroscopy with iliopsoas lengthening. You best bet is probably to use 29999 (Unlisted procedure, arthroscopy) for the procedure. In addition to reporting the 29999 code, you might want to compare the procedure to 27001 (Tenotomy, adductor of hip, open) for the payer's consideration.

If the payer rejects your claim, give them a call and see how they would like you to report arthroscopy with iliopsoas lengthening.

Background info: According to clinicalgate.com, "iliopsoas tendon lengthening has traditionally been a procedure that is performed with an open approach and that is used mainly for the treatment of coxa saltans interna or medial snapping hip syndrome. Other indications include iliopsoas irritation syndrome after hip arthroplasty and spastic hip subluxation. The evolution of surgical techniques and technology for hip arthroscopy has allowed for endoscopic techniques for the release or lengthening of the iliopsoas tendon."

Treatment: According to clinicalgate.com, the provider can perform endoscopic release of the iliopsoas either by release at the level of the insertion of the tendon on the lesser trochanter or release at the level of the hip joint by accessing the bursa through an anterior hip capsulectomy. With both techniques, the provider will perform a hip arthroscopy first.