Wiki BEAR Implant Coding ACL

[cgraziano]

Is it appropriate to code either 29888 or 27428 for the BEAR Implant? Based on the AMA/CPT vignettes, these procedures include graft harvesting which is not applicable to BEAR. As a new procedure, I can surmise that this is how it is being coded and is currently under the radar albeit it does not seem correct. Wondering if anyone has any confirmation from AMA or other reliable source. Thanks

 

[nraizman@gmail.com]

29888 code descriptor is for arthroscopic-assisted ACL Repair, Augmentation or Reconstruction. The code is implant-agnostic and graft-agnostic.
The BEAR procedure is an ACL repair with biologic augmentation and, if arthroscopically assisted, 29888 would be entirely appropriate.

Important to remember that the Vignette is primarily used for code valuation and defining the service work for the RUC process. It is meant to describe only a "typical case" and is not meant to limit or otherwise prescribe what constitutes the appropriate service. The GSD can be helpful if there is concern, but in this case, it is the code descriptor itself that clearly corresponds to the procedure.