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new coder needs opinion - Does anyone know

  1. #1
    Default new coder needs opinion - Does anyone know
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    Does anyone know if you can use code 29875 with a modifier 51 or 59 along with 29881?
    The physician wanted it coded 29875, 29879, 29881, but I know that you can only bill one thing per compartment. The synovectomy was in the anterior compartment, but is listed as a separate procedure and the menisectomy was in the medial compartment.

    I have an op note that reads: The lateral compartment was entered. There was seen early chondromalacia class II on the lateral compartment. The lateral meniscus was intact. The anterior compartment was entered. There was marked synovial reaction extending to the medial compartment. The motorized resector was introducted in order to debride the anterior compartment's synovitis in order to visualize. The medial compartment was entered. There was seen extensive chondrosis of the medial femoral condyle with subchondral bone exposure, loose fragments of cartilage were observed. The area compromising athe majority of weightbearing portion of medial femoral condyle. There was a complex tear involving the body and posterior horn of the medial meniscus. Motorized resector was introduced and the medial meniscus was resected in its body and posterior horn back to a stable rim. The bipolar Bovie was introduced and contouring of the residual body and posterior horn of the medial meniscus was carried off. Turning the medial femoral condyle, removing the residual margins of the loose articular cartilage showed an even larger exposure subchondral bone. Using a small pick, the chondral surface medial femoral condyle in the area of exposed subchondral bone was drilled on numerous locations getting good bleeding subchondral bone.

  2. #2
    This one is kind of confusing

    I show that medicare does NOT include 29881 & 29879, however, AAOS states that they can only be billed if separate compartments. I guess it depends on your payor. If it is a commercial payor I would try it, a lot of times they look to Medicare for guidance.

    There really is not an "anterior" compartment, EVERYBODY (cpt, ama,aaos, cms) accepts that there are 3 compartments medial, lateral, and patellofemoral. Your doc will need to be more specific(ha ha). If he is talking synovectomy in the the anterior portion of the medial compartment then you cannot bill for synovectomy. If he meant the patellofemoral then you can bill, but I would have the doc clarify.

    hope that helps a little

  3. #3
    Thank you for your help.

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