Wiki Cyclops Lesion - Arthroscopic

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Sara82

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I billed a synovectomy(29876), Chondroplasty(G0289) and unlisted code for Cyclops Lesion debridement(29999) coming from a previous ACL graft. The unlisted code was denied. Chondroplasty was performed in the patellofemoral compartment. Synovectomy and the Cyclop debridement were preformed int he same compartment.
Is this truely not paid seperate? Can anyone help me explain why this denial is valid or invalid.
New to Ortho coding and any help would be greatly appriciated.
Thank you!
 
They are probably including the lesion into the synovectomy code. I have had a couple of cyclops lesions in the past and I would have bundled everything done in that compartment into the unlisted code and priced accordingly, particularly synovectomy which are typically included into other codes.

I usually do not have good luck getting unlisted codes paid when other procedures are being done at same site.

You will probably have to have your doc do a letter of medical neccessity stating why the procedure needed to be done and why he feels it is separate from the synovectomy AND they still might not pay it.
 
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