Surgery Arthroscopy Includes Debridement (with an Important Exception)

In most cases, per CMS rules, surgical arthroscopy will include arthroscopic debridement of the same joint; therefore, you may not report the debridement separately.

For example, you should not separately report 29874 Arthroscopy, knee, surgical; for removal of loose body or foreign body (eg, osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)with other knee arthroscopy codes (29866- 29889), for Medicare payers.

There is an exception to this general rule: You may report G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chrondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee with other knee arthroscopy codes, for Medicare payers, but only if the removal or debridement occurs in a different compartment of the knee from the primary surgical service. Per Chapter 4 of the National Correct Coding Initiative (NCCI) Policy Manual:

Since CPT codes 29880 and 29881 (Surgical knee arthroscopy with meniscectomy including debridement/shaving of articular cartilage of same or separate compartment(s)) include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. HCPCS code G0289 should not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure.

When removal of a loose body or foreign body occurs in the same compartment of the same knee as another procedure, you may not report the procedure separately.

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John Verhovshek

John Verhovshek

John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.
John Verhovshek

About Has 402 Posts

John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.

One Response to “Surgery Arthroscopy Includes Debridement (with an Important Exception)”

  1. Liz Ward says:

    I do not agree with the statement that arthroscopic debridement/shaving (chrondroplasty) can be billed in addition to 29880 and 29881. The description of these codes changed in 2012, I believe, and specifically state “including debridement/shaving of articular cartilage (chrondroplasty), same or separate compartment(s)”. We have never received reimbursement for 29877/G0289 when billed with 29880 or 29881, which to me is clear given the description of the code.

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