Chondroplasty question for Medicare

bella2

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Hi, I new to ortho coding and was looking for advice, if our Doctor performs
a medial meniscectomy and a chondroplasty of the patella, can you bill 29881 and G0289 for Medicare or should I use 29877. I can't seem to get a clear answer on when to use the G-code and when to use the 29877. Also which insurance companies want the G-code reported.
Thanks in advance for all responses. :)
 

Lisa Bledsoe

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Always use G0289 for Medicare. We have found that most of our payers recognize the G code. We had to call them all to find out, but they do recognize it. Keep in mind that it can only be reported for a separate compartment than the primary procedure.
 

Bella Cullen

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G0289 for medicare when billed with another procedure.
Only if chondroplasty was the only procedure done then you would use 29877.
 

nyyankees

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Lisa-
We just started billing the G code to BC/BS. I was trying to get G-code information from other ins co's via their website. I see you had to call. Thanks, it's good to know if I run into the same problem that I had with BC/BS the G code can be used w/o spending too much time reseraching their sites.
:)
 

mitchellde

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Also when I was assisting with an ortho clinic in California we found that numerous commercial carriers had both 29877 and G0289 as payable in their system, however the reimbursement was always better for the G0289. Funny isn't it!
 

Lisa Bledsoe

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Lisa-
We just started billing the G code to BC/BS. I was trying to get G-code information from other ins co's via their website. I see you had to call. Thanks, it's good to know if I run into the same problem that I had with BC/BS the G code can be used w/o spending too much time reseraching their sites.
:)
The insurances we found that recognize the G code are: Cigna, UHC, BCBS, Great West, Aetna... I'm sure there are more, but that's all I can think of off the top of my head.
 

ASC CODER

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You can use G codes in an ASC the question would be why would you because they don't pay as much as the procedure. And really the only time you would use a G code in an ASC would be if there was not a procedure code for the what the doctor did.:) thought I would share my info because I had this same question and went to the chapter president and that is what she told me.

good luck
 

coderguy1939

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For an ASC facility, G0289 carries an N1 status code and can't be used. The level 1 equivalent is 29877 and is only used for Medicare patients when that is the only procedure being performed. G0289 can be used by the doctor.
 
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