Orthopedic Coding Alert
Appeal This BCBS Misconception
Question: I am having trouble with Blue Cross Blue Shield (BCBS) with my medial meniscectomy (29881) and lateral meniscal repair (29882) claims. Representatives tell me I can't use modifier 59 to charge both codes. Is their advice correct? South Dakota Subscriber Answer: Provided both procedures are distinct services, meaning your physician worked on separate compartments, you can report 29881 (Arthroscopy, knee, surgical; with meniscectomy [medial OR lateral, including any meniscal shaving]) with 29882 (- with meniscus repair [medial OR lateral]). The Correct Coding Initiative (CCI) bundles 29881 and 29882. When your documentation supports a separate compartment, then you should append modifier 59 (Distinct procedural service). Because CCI makes 29882 mutually exclusive to 29881, append modifier 59 to 29882 -- even though this is the higher valued code. Not all commercial payers follow this CMS guideline. If you receive a denial, be sure to appeal.
Orthopedic Coding Alert
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