Orthopedic Coding Alert

Question: Can we bill 29876, 29879 and 29880 together? Because 29880 includes the meniscectomy in both compartments and 29876 represents synovectomy in two or more compartments, we're afraid the insurer might deny the synovectomy.


Florida Subscriber

 
Answer: You're in luck - you can report all three services without a hitch, unless your payer publishes guidelines to the contrary. Neither the National Correct Coding Initiative (NCCI) nor the American Academy of Orthopaedic Surgeons' Global Service Data bundles the following codes into one another: 
 

29876 - Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
 

29879 - ... abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
 

29880 - ... with meniscectomy (medial AND lateral, including any meniscal shaving).
 
If the surgeon's documentation supports the fact that he performed all of these services, you should report 29880, followed by 29879-51 (Multiple procedures) and 29876-51.
 
If you treat a Medicare patient, you should omit modifier -51, because Medicare's multiple endoscopy rule makes the modifier use unnecessary.