Ishvindersingh..can you direct us to that Medicare rule? Are you confusing the 29877 with the 29879?
I have documentation from a coding seminar that I attended that states that the 29879 can be billed/coded per compartment.
Mary
Hi,
Mary must be stating this AAOS article published in
AAOS Bulletin, April 2005. It states that:
Abrasion arthroplasty
AAOS guidelines permit reporting of abrasion arthroplasty if the documentation supports that debridement was performed down to “bleeding bone.”
Abrasion arthroplasty is not limited by compartments and can be reported twice if performed in both the medial and lateral compartments (as 29879 and 29879-59 or -51, depending on carrier issues).
Many offices are reporting an abrasion arthroplasty (29879) when the documentation supports a chondroplasty (29877). Reporting a chondroplasty as an abrasion arthroplasty is considered “upcoding” and should not be done.
According to the AAOS GSD, code 29879 covers: synovial resection for visualization; removal of osteochondral and/or chondral bodies (attached); diagnostic arthroscopy; chondroplasty; lavage and drainage; lysis of adhesions, and manipulation of the knee. It does not include arthroscopic meniscectomy and/or repair or arthroscopic removal of loose bodies or foreign bodies 5 mm or greater and/or through a separate incision.
According to the August 2001 CPT Assistant, “When smoothing down the cartilage and/or drilling holes to create microfractures, code 29879 may be reported. Abrasion arthroplasty is usually performed to promote cartilage regeneration by creating access to blood and nutrients by smoothing down the cartilage and/or drilling holes to create microfractures. Code 29879 includes chondroplasty performed as part of the abrasion arthroplasty, so code 29877 should not be separately reported. If, however, chondroplasty is performed in a separate knee compartment, code 29877 may be reported separately. Modifier -59, Distinct Procedural Service, should be appended to indicate that a separate compartment was involved.”
The scenario depends on carrier issues. Medicare has always been tricky to understand than the local carriers and i believe we cannot completely rule out the Mary's view point.
We do follow AAOS and have never come upto any denials.
Thank You