Wiki Medicare Menisectomy/Loose Bodies

cwilson3333

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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
 
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:
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..
 
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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