Orthopedic Coding Alert

Question: My orthopedist performed a lateral and medial meniscectomy and a partial synovectomy in the lateral, medial and patellofemoral compartments. Can I report 29880 for the meniscectomy and 29876 for the synovectomy? Or is this bundled?

Answer: The Correct Coding Initiative (CCI) bundles 29876 (Arthroscopy, knee, surgical; synovectomy, major, two or more compartments [e.g., medial or lateral]) into 29880 (... with meniscectomy [medial AND lateral, including any meniscal shaving]). But the edit has a "1" modifier indicator, meaning you can break the edit in certain circumstances by using a modifier, such as 59 (Distinct procedural service). Your situation is a special circumstance. Because the orthopedist addressed all three compartments for the synovectomy and only the medial and lateral compartments for the meniscectomy, you can report the patellofemoral synovectomy separately. Your code would be 29875 (... synovectomy, limited [e.g., plica or shelf resection] [separate procedure]), and you must append it with modifier 59 to show that the surgeon performed the procedure in a separate compartment from the meniscectomy. Your physician should include a separate paragraph in the op-note labeled "Patellofemoral compartment." Your final claim for this procedure would look like this:

• 29880
• 29875-59.