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Orthopedic Coding Alert

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Reevaluate This Repair, Debridement, Resection Scenario

Published on Tue Aug 05, 2014

Question: According to my orthopedist’s op note, the patient underwent a medial meniscal repair with debridement of synovitis in the notch and lateral regions and patella femoral synovitis resection. The op note wording, however, is what is throwing me off. Should I: A) bill 29882 with 29877 (G0289) x 2 for the synovitis debridement in the notch and lateral regions and 29875 for the patellofemoral resection, or B) only bill 29882 and 29876-59 because the orthopedist did the synovectomies in two or more compartments?

California Subscriber

Answer: None of the above. You should report only 29882 (Arthroscopy, knee, surgical; with meniscus repair [medial OR lateral]) for the medial meniscal repair or medial compartment. You would link this CPT® code with diagnosis 836.0 (Tear of medial cartilage or meniscus of knee current) or diagnoses 717.0-717.3 (Derangement of medial meniscus …). 
 
According to the revised CPT®/AAOS guidelines effective January 2013, you can only report 29876 (Arthroscopy, knee, surgical; synovectomy, major, two or more compartments [e.g., medial or lateral]) when the document establishes medical necessity of synovial pathology, not just cleaning up loose synovium that might be fibrillating the joint. Because you have not provided any documentation of synovial pathology that would support reporting 29876, you should not report that code.

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