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Chondroplasty question for Medicare

  1. Default Chondroplasty question for Medicare
    Medical Coding Books
    Hi, I new to ortho coding and was looking for advice, if our Doctor performs
    a medial meniscectomy and a chondroplasty of the patella, can you bill 29881 and G0289 for Medicare or should I use 29877. I can't seem to get a clear answer on when to use the G-code and when to use the 29877. Also which insurance companies want the G-code reported.
    Thanks in advance for all responses.

  2. #2
    Location
    Greeley, Colorado
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    Always use G0289 for Medicare. We have found that most of our payers recognize the G code. We had to call them all to find out, but they do recognize it. Keep in mind that it can only be reported for a separate compartment than the primary procedure.
    Lisa Bledsoe, CPC, CPMA

  3. Default
    G0289 for medicare when billed with another procedure.
    Only if chondroplasty was the only procedure done then you would use 29877.

  4. Default
    Exactly..G0289 is an add-on code and needs to be billed with a primary procedure. If all you are doing is the chondroplasty...then use 29877
    Ann Marie CPC
    Watertown, CT

  5. #5
    Location
    Long Island/New York
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    1,271
    Thumbs up
    Lisa-
    We just started billing the G code to BC/BS. I was trying to get G-code information from other ins co's via their website. I see you had to call. Thanks, it's good to know if I run into the same problem that I had with BC/BS the G code can be used w/o spending too much time reseraching their sites.

  6. Default
    ConnectiCare also recognizes G0289
    Ann Marie CPC
    Watertown, CT

  7. #7
    Location
    Columbia, MO
    Posts
    12,940
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    Also when I was assisting with an ortho clinic in California we found that numerous commercial carriers had both 29877 and G0289 as payable in their system, however the reimbursement was always better for the G0289. Funny isn't it!

    Debra A. Mitchell, MSPH, CPC-H

  8. #8
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    I don't think we can use G-codes at a ASC? Correct me if I am wrong?

  9. #9
    Location
    Greeley, Colorado
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    Quote Originally Posted by martn View Post
    I don't think we can use G-codes at a ASC? Correct me if I am wrong?
    That is correct.
    Lisa Bledsoe, CPC, CPMA

  10. #10
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    Greeley, Colorado
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    Quote Originally Posted by nyyankees View Post
    Lisa-
    We just started billing the G code to BC/BS. I was trying to get G-code information from other ins co's via their website. I see you had to call. Thanks, it's good to know if I run into the same problem that I had with BC/BS the G code can be used w/o spending too much time reseraching their sites.
    The insurances we found that recognize the G code are: Cigna, UHC, BCBS, Great West, Aetna... I'm sure there are more, but that's all I can think of off the top of my head.
    Lisa Bledsoe, CPC, CPMA

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