Wiki Is coding CPT 29888 for a repair appropriate? - One of the hospitals that my surgeon

[dmarcum]

One of the hospitals that my surgeon has privileges gave a directive that for an ACL Repair we cannot use 29888 because they will not accept it for their billing stating it is for reconstruction only and not repair but in the AMA and AAOS definition of the code: "Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction". The hospital stated we would have to use the unlisted 29999 which we know will not be paid. Can anyone validate the hospital's position? I believe they are incorrect in advising this and must follow the surgeon's lead on the coding correctiveness.

 

[thomas7331]

I have never heard of this and if I were in your place I would contact the hospital to get more information. There may be a contractual reason for this, or they may have specific situations where they don't want the code used. In any case, if your surgeon is not employed by the hospital and the hospital is not billing for your physician's professional services, they cannot dictate how you code. Your practice is ultimately responsible for the accuracy of the codes you submit, not the hospital.