Wiki Subchondroplasty

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cpccpma

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Hello-I am hoping someone might have additional info on this procedure. I know there is a new code as as of 1/22-0707T however wouldn't that code be billed on the ASC/Hosp side? They get the kit the doc does not-he will perform an arthroscopy and possibly clean up some cartilage and remove some loose bodies (knee) so he would bill 29877 and nothing for the subchondroplasty correct? Any and all input would be great! Have a wonderful weekend!

Michelle, CPC
 
cpccpma said:
Hello-I am hoping someone might have additional info on this procedure. I know there is a new code as as of 1/22-0707T however wouldn't that code be billed on the ASC/Hosp side? They get the kit the doc does not-he will perform an arthroscopy and possibly clean up some cartilage and remove some loose bodies (knee) so he would bill 29877 and nothing for the subchondroplasty correct? Any and all input would be great! Have a wonderful weekend!

Michelle, CPC
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did you ecer find an answer to this? I am having the same problem. My physician wants to bill for the 0707T but it seems to me that it would be just the facilty code.
 
Question:
Our surgeons occasionally perform subchondroplasty procedures. We are reporting this with an unlisted code and are wondering if this is correct.

Answer:
Yes, through the remainder of 2021 you will continue to report an unlisted CPT code. The AMA released a new Category III code in July 2021, but it is not effective until January 1, 2022.
0707T: Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization

The following guidelines apply to this new Category III code:
  • Do not report 0707T in conjunction with 29805, 29860, 29870, 77002
  • For aspiration and injection of bone cysts, use 20615
 
0707T is for the performance of the subchondroplasty by the surgeon. We used to report unlisted for this but now that there's a Cat III code, you would use that. Some payers may not want/accept this Cat III code so you would want to check. Also, some may not cover it.
 
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