Orthopedic Coding Alert

Question: What is the difference between a diagnostic and a surgical elbow arthroscopy, and how do I code each?

Tennessee Subscriber

Answer: In a diagnostic elbow arthroscopy, the provider performs the arthroscopy to look for further problems in the elbow — like a pull, tear, etc. During the diagnostic arthroscopy, if the provider doesn’t perform any repairs/revisions during the arthroscopy — but does provide diagnostic services — then you’d report 29830 (Arthroscopy, elbow, diagnostic, with or without synovial biopsy (separate procedure)).

If, however, the diagnostic arthroscopy turns up a problem that the provider needs to address surgically, then you’ll forget about 29830 and choose from one of the following codes, depending on encounter specifics:

• 29834 (Arthroscopy, elbow, surgical; with removal of loose body or foreign body)
• 29835 (… synovectomy, partial)
• 29836 (… synovectomy, complete)
• 29837 (… debridement, limited)
• 29838 (… debridement, extensive)

No double-dipping: Remember, if the provider begins a diagnostic arthroscopy and then switches to a surgical intervention, you should only report a surgical code from 29834 through 29838. You cannot report a diagnostic and surgical arthroscopy for the same body part during the same session when diagnostic becomes surgical, so leave 29830 off your surgical wrist arthroscopy claims.