Wiki Disagree with provider coding 29876 & G0289

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MiMimed

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Happy Friday all!!

Hoping someone can help with this one. I am not agreeing with my provider on this one.

Op Report states:

"Standard arthroscopy portals were performed, anteromedial, anterolateral and superomedial.

A fair amount of synovitis was noted throughout the entire knee joint and synovectomy was performed.

After synovectomy was performed I was able to visualize all the compartments of the knee. Patellofemoral joint was within normal limits.

Medial compartment of knee shows a tear of the posterior horn of the medial meniscus, partial meniscectomy was performed. Also a tear of the anterior horn of the medial meniscus was seen and partial meniscectomy was performed.

In the intercondylar notch the anterior cruciate ligament was intact. In the lateral compartment of the knee the radial tear of the free edge of the body of the meniscus was seen and partial meniscectomy was performed until stable edges were seen. All debris was extracted and portals closed."

Physician wants to bill 29876 and G0289. I think only 29876. Any thoughts?

Thank you!!!
 
Medial and Lateral Meniscectomies

According to this operative note, medial and lateral meniscectomies were performed. These are considered the primary procedures and coded as 29880 (includes both medial and lateral meniscectomies).

The note also documents an extensive synovectomy (29876) however per the NCCI, CPT 29876 cannot be reported with 29880.

G0289 should only be used for removal of loose bodies when performed in conjunction with other arthroscopic procedures in the same operative setting when the removal of loose bodies is the only service rendered in that compartment of the knee. This note does not document any removal of loose bodies so it is not applicable to this surgery.

Best Regards,

Elizabeth Redman, CPC, COSC
Billing Department Manager
Buffalo, NY
 
Any procedure "For Visualization" is also not reported

Any procedure done in an effort to visualize the surgical field is not reported separately. Per the doc he states that after synovectomy he as able to see the surgical field (three compartments). It's possible that at least some of the synovectomy was required for visualization. That would need to be clarified and documented if not. Just one more thing to keep in mind as coders.
 
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