Wiki Billing Chondroplasty, Plica Excision and Removal of Loose Bodies in knee

[danielawhit]

Question:

My doctor is trying to bill 29877, 29874, and 29875 all at the same time. When looking at my NCC edits book I see that normally you can only bill 29877 (has the highest RVU value).

However, my doctor clearly states in his documentation that he removed loose bodies from the lateral compartment, did the chondroplasty in the patellofemoral compartment, and did the plica excision in the medial compartment.

I always get confused on if I can bill per compartment or if it's strictly a no bill together thing. The insurance on this particular patient is Champus, just FYI.

Thanks.

 

[PLAIDMAN]

Question:

My doctor is trying to bill 29877, 29874, and 29875 all at the same time. When looking at my NCC edits book I see that normally you can only bill 29877 (has the highest RVU value).

However, my doctor clearly states in his documentation that he removed loose bodies from the lateral compartment, did the chondroplasty in the patellofemoral compartment, and did the plica excision in the medial compartment.

I always get confused on if I can bill per compartment or if it's strictly a no bill together thing. The insurance on this particular patient is Champus, just FYI.

Thanks.

there is AAOS now article...Jan 2013 issue, coding knee arthroscopies. States compartment rules do NOT apply to 29875, it is separate proced and should not be billed unless it is ONLY procedure being done.

you should be able to capture LBR with chondroplasty in sep compartment.