Who else saw the CPT Assistant for May 2014?. On page 10, under frequently asked questions, it states the following:
Surgery: Musculoskeletal System
Question: A patient had a medial compartment meniscectomy (29881) and a lateral compartment synovectomy (29875), and both procedures were performed in different compartments of the knee. Would it be appropriate to separately report these procedures?
Answer: No. Code 29875, which describes a limited synovectomy is for a separate procedure. This means that the work associated with this procedure is inclusive to more extensive procedures performed in the same anatomic site (the knee), and is not separately reportable if other arthroscopic knee procedure is performed on the same knee in the same session. This code should only be reported if it is the only procedure performed; separate compartment rules do not apply. Code 29875 is a separate procedure and is not reported with code 29881 when performed.
This directly contradicts the prior guidance from CPT Assistant/AMA given back in August 2001:
"Code 29875 is designated as a "separate procedure." Codes with the "separate procedure" designation normally would not be additionally reported when the procedure or service is performed as an integral component of another procedure or service. However, when a procedure or service designated as a separate procedure is carried out independently or is considered unrelated or distinct from the other procedure(s) or service(s) provided at that time, then it would be appropriate to report the code in conjunction with the other procedure(s) or service(s). Modifier -59, Distinct Procedural Service, should be appended to the separate procedure code to indicate that the procedure was distinct from the overall procedure. For example, if the knee arthroscopy with limited synovectomy were performed in a different knee compartment than another knee procedure."
I expect a lot of heated discussion to be raised about this. And since this is new position for CPT Assistant / AMA to take, I am waiting until all the dust settles before I look at changing how I code knee procedures.
What is everyone else doing?
Surgery: Musculoskeletal System
Question: A patient had a medial compartment meniscectomy (29881) and a lateral compartment synovectomy (29875), and both procedures were performed in different compartments of the knee. Would it be appropriate to separately report these procedures?
Answer: No. Code 29875, which describes a limited synovectomy is for a separate procedure. This means that the work associated with this procedure is inclusive to more extensive procedures performed in the same anatomic site (the knee), and is not separately reportable if other arthroscopic knee procedure is performed on the same knee in the same session. This code should only be reported if it is the only procedure performed; separate compartment rules do not apply. Code 29875 is a separate procedure and is not reported with code 29881 when performed.
This directly contradicts the prior guidance from CPT Assistant/AMA given back in August 2001:
"Code 29875 is designated as a "separate procedure." Codes with the "separate procedure" designation normally would not be additionally reported when the procedure or service is performed as an integral component of another procedure or service. However, when a procedure or service designated as a separate procedure is carried out independently or is considered unrelated or distinct from the other procedure(s) or service(s) provided at that time, then it would be appropriate to report the code in conjunction with the other procedure(s) or service(s). Modifier -59, Distinct Procedural Service, should be appended to the separate procedure code to indicate that the procedure was distinct from the overall procedure. For example, if the knee arthroscopy with limited synovectomy were performed in a different knee compartment than another knee procedure."
I expect a lot of heated discussion to be raised about this. And since this is new position for CPT Assistant / AMA to take, I am waiting until all the dust settles before I look at changing how I code knee procedures.
What is everyone else doing?