Wiki Arthroscopic synovectomy & chondroplasty

[CWISNER]

I need clarification on billing for an arthrocopic synovectomy and chondroplasty. If the surgeon is doing med. & lat. meniscectomies along with an extensive synovectomy and extensive debridement; I know we can bill for the patellofemoral compartments with the appropriate modifers; but are the synovectomy and debridement allowed to billed together? Any advice would much apprieciated!

 

[mbort]

no they are not. If you already have codes that are applicable to all three of the compartments, then you would not be able to code out the synovectomy seperately, they are bundled.

 

[CWISNER]

The synovectomy would be reduced to 29875 w/ a 59 mod., so could you bill a 29877 w/59 or G0289 along with the synovectomy?

 

[mbort]

my answer would be no because you have already compensated for being in all three compartments therefore the debridement would not be seperately reportable for any of the compartments.

 

[CWISNER]

Thank you!

 

[trose45116]

i dont have any problems getting paid by some of the insurance company's billing those codes together.

 

[CWISNER]

Do you use modifiers and do you remember which ins. companies pay you?

 

[mbort]

From a coding perspective, (per our guidelines) it would be incorrect to bill them together regardless as to whether the carrier pays them or not. Should you ever be audited, you should be prepared to pay the consequences (refunds, fines, etc). By adding modifiers you are "coding for payment" which is not what we were trained to do.

just my two cents
Mary

 

[CWISNER]

All input is apprieciated!

 

[kjansen]

hip arthroscopy

if a surgeon performs a hip arthroscopy, can he also code 27179 (osteoplasty of the femoral neck) and 27120 (acetabuloplasty)? He does not document that the arthroscopic service was converted to an open procedure. My answer would be no, but i would like to hear from the floor. His position is that these services are not detailed in the CPT book.