Wiki 29870 with 27446, 27487, 27437

[mmunoz21]

I'm not an expert in Ortho, so my question is this: A Dr. bills for 29870 Knee arthroscopy (separate procedure), along with 27446 Knee Arthroplasty., or 29870 along with 27487 Revisio of knee arthropalsty, of course modifier 59 is on both codes...

Why bill for the Diagnostic Arthroscopy if you are aleady going in the knee for the major procedure?? Is the same knee, not LT or RT.... I'm trying to locate any info on this.. The NCCI edits have 27446 column 1 and 29870 column 2 with status indicator 1 (modifier allowed)...

 

[mitchellde]

I am not sure where you will find the support other than what you have with the CCI edits but .. you may not bill for a diganostic procedure when it is followed by a definitive procedure, like a diagnostic arthroscope and a definitive open procedure. This is very common is a lot of ortho practices to use a scope to sort of scope it out (sorry could not resist!) and then determine if an arthroscopic or open procedure is the ticket. If the did the repair via the scope you would not bill for the diagnostic and the repair. The reason it is modifiable is if you did an the scope for the other knee or other area for a totally different reason. I hope this has been of some assistance to you.

 

[mmunoz21]

Thank you that's what I thought...