29877 Help, Help.....

pinnaclephyserv

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Technique right knee arthroscopy with large partial posterior horm medial meniscectomy chrondroplasty of the medial femoral condoyle the the trochlea and the partial posterior horn medial meniscectomy chrondroplasty of the medial femoral condyle the trochlea and the undersurface of patella. Removal of intercondylar notch synovitis and transverse fibrotic band right knee.were used the intra articul

the right leg was sterile prep draped exsanguinated and placed in leg holder. The2 parapatellar portals were used the intra articular findings were there was diffuse synovitis were there diffuse synovitis throughout the kneww. there was a communuted tearing of the posterior horn of the medial meniscus degenerative in nature. Through about the medial compartment the articular surface was very friable. The medial femoral condyle had a flap articular tears. a large partial posterior horn medial meniscectomy was performed and a chrondroplasty performed of the medical femoral condyle. anteriorly the knee in the intercondylar notch are had extensive synovitis. In debriding this there was also a fibrotic transverse band. both were removed. the cruciate ligaments were intact but hypermic. there was difficult time seen in the good condition and therefore after several attempts further attempts at seen in the lateral compartment were deemed to be counterproductive. the anterior compartment showed extensice chondromalacia changes of the patella and the troclear groove both a grade 3 nature that on the trochlear groove was a deep grade 3 nature . both areas were debrided with a chondrotome to remove the loose and frayed. the gutters showed hypertrophic synovium. knee was 3 arthroscope several times no further issues were identified. the knee was filled with 20 ml of 0.5 naropin and kenalog. the 2 port we closed with glue

It's Monday morning blues with coding
 
Code is 29881

Look at 29877 in the CPT. It states that if meniscectomy is performed to use 29880, 29881.

You would never be able to bill 29881 with 29877 unless they were performed on separate knees.
 
Some payers may require use of G0289, which may be reported when a chondroplasty is performed at the time of another arthroscopic procedure in a different compartment of the same knee.
 
Monday Morning all week long with 29877

This code will drive you nuts. It seems it depends on who you ask. Multiple sources tell us different things:

According to the NCCI Manual:
CPT codes 29874 (Surgical knee arthroscopy for removal of loose body or foreign body) and 29877 (Surgical knee arthroscopy for debridement/shaving of articular cartilage) should not be reported with other knee arthroscopy codes (29866-29889).

According to CPT, code 29877 (Arthroscopy, knee, surgical; debridement/shaving of articular cartilage [chondroplasty]) should be reported to indicate the performance of an arthroscopic chondroplasty in the medial, lateral, and/or patellofemoral compartment(s). This code may only be reported one time per surgical session and may only be reported if the chondroplasty is performed in a separate compartment from the primary surgical procedure. https://www.aaos.org/AAOSNow/2010/May/managing/managing2/?ssopc=1

Chondroplasty, loose/foreign body coding basics According to CPT, code 29877 (Arthroscopy, knee, surgical; debridement/shaving of articular cartilage [chondroplasty]) should be reported to indicate the performance of an arthroscopic chondroplasty in the medial, lateral, and/or patellofemoral compartment(s). This code may only be reported one time per surgical session and may only be reported if the chondroplasty is performed in a separate compartment from the primary surgical procedure.. Chondroplasty, loose/foreign body coding basics

and many more....
 
Keep this in mind

In 2012 the AMA combined 29877 with 29881. So if meniscectomy is performed, in any compartment, the correct code to choose is 29880 or 29881.

Part of the CMS NCCI policy manual has been updated to reflect this. See page 7. Code G0289 can only be used with 29880 or 29881 if for loose body only.

The policy manual also specifically states that 29877 should not be billed with any other arthroscopic code.
 
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