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Coding Question - work for orthopaedicts

  1. Default Coding Question - work for orthopaedicts
    Medical Coding Books
    I work for orthopaedicts and they continuously want to code...say 29880 with 29875. But we are not allowed to put those together which infuriates the surgeons. Is our system keyed wrong or is this true? Present patient is Medicare and the documentation mentions both procedures which is on the same knee. Please help resolve this issue!

  2. #2
    Default
    In this situation, the American Association of Orthopedic Surgeons states the following:
    Synovectomy procedures in the knee
    Synovium is the smooth lining of the joint that produces synovial fluid to lubricate the joint. Every surgical procedure in the knee includes synovial resections to clean up the joint for visualization. The following CPT codes describe synovectomy procedures in the knee:

    29875: Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (separate procedure)
    29876: Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments (eg, medial or lateral)
    CPT code 29875, limited synovectomy, is described as a ?separate procedure.? This means that the work associated with this procedure is inclusive to more extensive procedures performed in the same anatomic site (the knee) and is not separately reportable. This code should only be reported if it is the only procedure performed; separate compartment rules do not apply.

    CPT code 29876 describes a major synovectomy and may be reported in two or more compartments when performed. This is where the coding becomes a bit confusing.

    Medical necessity
    Surgeons commonly perform a synovectomy in addition to other procedures to ?clean up? the joint while performing more extensive surgery. Reporting either synovectomy CPT code (29875 or 29876) for these surgical cases would not be appropriate.

    Also, in this situation, the description of 29880 states that the synovectomy is inherent to the procedure as well. However, as stated above, if the physician performs a synovectomy of 2 or more compartments then, this would be a more intensive surgery and therefore would be reported separately.

    Hope this helps you
    Amy Pritchett,
    BSHA, CPC, CPMA, CPC-I, CDEO, CANPC, CEDC, CASCC, CRC, CMDP, CMPM, CCS, CMRS, C-AHI, ICDCT-CM, ICDCT-PCS
    2017-2018 Secretary of Local Mobile AAPC Chapter
    2015-2016 President of Local Mobile AAPC Chapter

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