Wiki Where to find additional code description

Create Wiki
V

Victoria323

Networker
Messages
26
Location
Manitowoc, WI
Best answers
0
Hello!

I am not sure where to find this additional information when coding, but for example, the AMA CPT book states that 29888 is the Arthroscopic ACL repair. The AMA just gives that description, yet I am told it includes the graft. Where do I look to find out if a code includes additional procedures like a graft or mesh..etc when the AMA book doesnt give further description?

Is there another program/reference I should be searching in addition?

Thank you!
 
I do not believe there is another document or source (unless the CPT Assistant is indicated). A graft is considered a standard/routine aspect of an ACL repair/augmentation or reconstruction, so it is included in the code.

Essentially, if a procedure is considered a standard occurrence for the primarily charged procedure, it is rarely coded separately, because payment is included in with the primary code. Much like in a surgery, you do not code for incision, because that is an integral part of any surgery and payment in included in the code you choose for the surgery.



"You usually can't bill for tendon grafts when used for arthroscopic ACL repairs. However, under certain conditions you can. Read on to find out why.

The CPT Manual states that CPT code 20924, indicates a tendon graft obtained "from a distance." You cannot bill this code separately from CPT code 29888 (ACL repair where a tendon graft is obtained from a separate incision on the same knee, which is the standard in these types of procedures). This does not constitute a far enough distance to bill for it separately, according to the CPT Assistant.

The tendon graft procedure is only billable when the graft is obtained from the ankle area on the same leg, from the opposite knee, or from another distant area."

http://www.hcpro.com/HOM-75189-2949...tendon-grafts-with-ACL-repair-procedures.html
 
You must log in or register to reply here.
Top