Knee arthroscopy

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Operation performed

arthroscopy right knee, joint debridement with synovectomy, partial medial menisectomy, chondroplasty patellofemoral joint, medial and lateral. Partial lateral menisectomy performed also.

Question on procedure coding
according to operative note, suprapatella pouch, medial and lateral gutters had inflammed synovium and thickened synovium, extending to notch, all which was taken down with electrocautery and shaver
would this meet coding cpt 29876???

or am i just looking at cpt 29880 for this surgery
 

lulu69

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Knee scope Q response

Hello
you can't bill a 29880 and 29876 together, because you can't bill for more than one procedure per compartment.To bill these together would be double dipping for the medial and lateral compartments.
29880 encompasses the medial and lateral compartments, which includes the chondroplasty regardless of compartment
This leaves the synovectomy for the patellofemoral compartment. 29875 is the code for this, but because it has a "separate procedure" designation it bundles
End code: 29880

or if there's enough documentation to warrant a 29876. 29876 does not have a separate procedure designation.
29876 Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments (eg, medial or lateral)

Major synovectomy involves resection of pathologic synovial disease from two or more knee compartments. To report 29876, it’s not enough for the surgeon to simply “clean up” the joint while performing more extensive surgery. — not just cleaning up loose synovium that might be fibrillating in the joint.”

29876 medial and lateral compartments
29877 patellofemoral compartment or G0289 for Medicare

I believe 29876 has higher wRVU's than the 29880. It comes down to the documentation and the primary reason for the surgery.

I'd say 99% of the time, this case would be coded 29880 with dx of the meniscal tears ahead of the other dx.

Knee scopes can be tricky
 
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Arthroscopy knee

Thank you for your response.

I actually didn't think I could do 29876, and know that I don't bill chondroplasties with the meniscectomies.
Just like to check myself every now and then.
Maybe one of these days we will be able to bill the chondroplasties [29877] with the meniscectomies [29881-29880]

Thank you again for answering and your detailed explanation. Helps me and hopefully anyone else who takes a look
 
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