Wiki Bone Spur Removal of The Knee

[hazlettjn87]

Hi! My ortho performed a knee arthroscopy with major synovectomy, extensive lysis of adhesions, arthroscopic removal of bone spur, and manipulation under andesthesia for pain and crepitus status post total knee arthroplasty. The doctor indicated codes 29884 (lysis of adhesions), 29876 (synovectomy, major), 27570 (manipulation under anesthesia), and 29999 for the bone spur removal.

I am having difficulty finding a procedure code to compare the arthroscopic bone spur removal to for my 29999 pricing letter. Any advise would be greatly appreciated!

Thanks

 

[OCD_coder]

The NCCI edits are telling me that the only CPT code that you can bill is the 29876, all of the other CPT codes you have listed are considered inclusive and cannot be billed separately. A synovectomy is only billable separately if performed on the contralateral knee as it is a "Separate Procedure" by CPT description. Just because there are separate compartments of the knee does not apply in this code combination given, to support using a modifier 59.

In reviewing other CPT code in the AAOS Global Service Data regarding the bone spur, most codes include bone spur removal with other work performed. It would be difficult to support billing this work separately with an unlisted code. A debridement code would apply best for a Like code, the 29877 would be my suggestion.