Orthopedic Coding Alert

Answer: Unfortunately, it appears that the denial you received from the carrier was correct. Code 29877 is not a separate compartment code and should not be reported multiple times when arthroscopic debridement or chondroplasty is performed in more than one compartment of the knee. Furthermore, 29875 has a separate procedure designation, which means it is normally considered to be an integral component of another more comprehensive procedure.

A limited synovectomy is inherent in most arthroscopic surgical procedures of the knee as it affords optimum visualization of the knee joint, hence its designation as a separate procedure. Normally, it would only be appropriate to report 29875 if additional procedures were carried out at different anatomic site, for treatment of a separate injury or via a separate incision.

If your physician feels that the work he or she performed was above and beyond what would normally be associated with an arthroscopic debridement or chondroplasty of the knee, append modifier -22 (unusual procedural services) to 29877. Remember that use of modifier -22 requires submission of a special report that clearly explains why additional reimbursement is warranted.