Wiki 29877 denied

[coders_rock!]

HELLO, Dr. was paid for 29880 & 29879. Do you think 29877 is payable, why or why not?


Medial Lateral Patello-femoral
29876 29876 29876
29880 29880 29879
29877 29877

 

[skorkfranks]

Information I have states that 29877 cannot be billed with other arthroscopic procedures on the same knee. Hope this helps.

 

[alb7585]

I've had it paid with a mod -59 when it applies and is clearly dictated as a seperate procedure

 

[coders_rock!]

Hey guys, thanks, I just realized that 29879 includes a chondroplasty wherever performed, so it's incidental.

 

[Claudia Yoakum-Watson]

The 29877 is included in the other procedures if performed in the same compartment of the knee. If ithe 29877 was performed in a different compartment of the knee, it is billable. When the 59 is appended to the 29877, you are indicating that it was done in a different compartment, different session, etc. The medical record needs to support that it was a distinct procedure, eg. performed in different area, etc.

 

[mitchellde]

If you look at the CCI edits, 29877 is bundled with the 29880 and is NON modifiable. You may not append a 59. You can however use the G0289 for the chondroplasty in separate compartment. This is carrier discretion allowed and most carriers do accept the use of this G code.

 

[nrichard]

Don't underestimate the power of line 19 on your HCFA

When I come across these I will lable out (**** first code)- medial compartment, (***secondcode-59)-patellar compartment. When I do this I rarley see denials for these claims. Of course this only works when the physician you are coding for makes it abundently clear in his documentation. I've been fortunate that my physicians document even when they change portals with the scope.