29874 with 29881


Georgetown, TX
Best answers
Question: I understand that normally the 29874 (loose body removal) is bundled into 29881 however according to AAOS Global Service Data/ Code X it states that it is billable if the loose body is greater than 5mm or thru separate incision--we have a case where the doctor removed a 1cm x 1cm loose body in the same compartment as 29881 so is this billable --does it have to be separate compartment?

Sharon D CPC
Good question. If you even look further in the codex and click on the cci-include button- it states 0 for modifiers- that there is no circumstance in which 29874 can be billed with 29881. I have been to seminars that state you can if well documented and the loose body is greater than 5 cm, but I am not sure myself after the edits are different in both places. ???
It is my understanding that, according to AAOS, as long as the loose body is greater than 5 mm, it can be billed separately no matter which compartment it is in. I know the CCI edits differ. However, we were told at a seminar to use the AAOS Global Service Data to fight denials on this matter. We were also told that "or thru a separate incision" means that a new portal has to be established for the removal of the loose body in addition to the normal portals already established. Hope that made sense.