Medicare Menisectomy/Loose Bodies

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Question regarding Medicare patient who has an Arthroscopic Menisectomy and Arthroscopic Removal of Loose Bodies.

Can we not bill for the 29874 [Loose Bodies] with the 29881 [Menisectomy] with
Medicare?

What about Commerical Insurances?

I know the Choncroplasties [29877] are now bundled into the 29881.

"Patient"ly waiting,

Thanks
CW
 

OCD_coder

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Revision of answer:

Per MCR CCI edits 29881/29874 code combination cannot be unbundled, there is 0 in the 3rd collumn, thus you cannot bill a 29874-59 even if it's in a different compartment. A physician probably is not going to make a separate incision just to remove a foreign body, this would be a rare and extreme case where the size would be the determining factor. We have had to refund money in this very situation and we cannot appeal. Beware.
 
Last edited:

nyyankees

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Question regarding Medicare patient who has an Arthroscopic Menisectomy and Arthroscopic Removal of Loose Bodies.

Can we not bill for the 29874 [Loose Bodies] with the 29881 [Menisectomy] with
Medicare?

What about Commerical Insurances?

I know the Choncroplasties [29877] are now bundled into the 29881.

"Patient"ly waiting,

Thanks
CW
G0289 - loose body greater than 5mm. Be prepared to appeal due to 29877 bundling issue..
 

Bella Cullen

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Question regarding Medicare patient who has an Arthroscopic Menisectomy and Arthroscopic Removal of Loose Bodies.

Can we not bill for the 29874 [Loose Bodies] with the 29881 [Menisectomy] with
Medicare?

What about Commerical Insurances?

I know the Choncroplasties [29877] are now bundled into the 29881.

"Patient"ly waiting,

Thanks
CW
According to the AAOS it says: for 29881: Intraoperative services not included in the global service package:
arthroscopic removal of loose (nonmeniscal) or foreign bodies greater than 5 mm and/or through a separate incision (eg, 29874)

then the cci edit says to put a 59 on 29874 when billed w/ 29881. (as long as the foreign bodies are greater than 5mm and/or through a sep incision.)
 
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