Orthopedic Coding Alert

Question: Our orthopedist began performing a diagnostic arthroscopy of the patient’s right metacarpophalangeal joint. During the arthroscopy, the orthopedist switched from diagnostic to surgical, and also debrided the joint. I was going to report 29900 with modifier 52 or 53, and 29901. What do you think?

Alabama Subscriber

Answer: This is a one-code claim, unless your orthopedist performed some other service you didn’t describe during this encounter. On the claim, report 29901 (Arthroscopy, metacarpophalangeal joint, surgical; with debridement) for the arthroscopy with modifier RT (Right side) attached to indicate laterality, if the payer requires it.

No Dx arthroscopy? You cannot report 29900 (Arthroscopy, metacarpophalangeal joint, diagnostic, includes synovial biopsy) and 29901 for the same patient during the same encounter. An arthroscopy cannot be simultaneously surgical and diagnostic. Per CPT^®, all surgical arthroscopies include a diagnostic arthroscopy.

And since you shouldn’t report 29900 for this claim, there is no need for either modifiers 52 (Reduced services) or 53 (Discontinued procedure).