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Knee Scope - Multi Procedures in All 3 Compartments

  1. #1
    Question Knee Scope - Multi Procedures in All 3 Compartments
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    I am having a disagreement with my biller so rather than assume I'm right I will post this question....

    Unless things have changed very recently that I'm not aware of scope procedures done in separate compartments than the primary procedure are separately reimburseable even by Medicare. Is this still true? My biller is convinced that because CCI shows a 0 under the modifier allowed column we cannot be reimbursed separately.

    The scenario is this: medial meniscectomy and chondroplasties in both the lateral and patellofemoral compartments. I coded 29881, 29877-59, 29877-59.

    Any thoughts or resources would be appreciated. Thank you!

  2. #2
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    Quote Originally Posted by broncsrox View Post
    I am having a disagreement with my biller so rather than assume I'm right I will post this question....

    Unless things have changed very recently that I'm not aware of scope procedures done in separate compartments than the primary procedure are separately reimburseable even by Medicare. Is this still true? My biller is convinced that because CCI shows a 0 under the modifier allowed column we cannot be reimbursed separately.

    The scenario is this: medial meniscectomy and chondroplasties in both the lateral and patellofemoral compartments. I coded 29881, 29877-59, 29877-59.

    Any thoughts or resources would be appreciated. Thank you!
    It can be a bit trickier for non-Medicare patients. Many third-party carriers are adopting the G code and requiring its use (instead of 29877) in reporting chondroplasties performed concurrent with other arthroscopic knee procedures. Carriers should understand that the G code can be reported more than once, provided each mention is for a separate compartment. However, code 29877 can be reported only once, regardless of how many compartments are affected.

    http://www2.aaos.org/aaos/archives/b...apr05/code.asp

  3. Default
    Hello

    PER CPT ASST.
    Year: 2001

    Issue: August

    Pages: 5

    Title: Arthroscopic Knee Procedures


    "29877Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)

    Code 29877 describes smoothing of roughened or damaged cartilage surrounding one or more of the articular ends of the bones in the knee joint by debridement or shaving. This code should be reported only one time, regardless of how many areas are debrided or shaved."


    Commerical Carriers (not following CCI)
    29881
    29877-59 (can only bill once)

    CMS
    29881
    G0289 per compartment

    Hope this helps!!!!!!!!

  4. #4
    Default
    I believe that will help. Thank you to both of you. I will have my biller run the G code through to see if that's what they require. We're dealing with BCBS which is always a challenge.

  5. Default Which BCBS
    If its BSMA, use the G code as BSMA goes by CMS guidelines.

    HL McIntyre

  6. Default
    Ive come across this scenerio a few times and BCBS pays
    29881
    G0289
    G0289/59

    Only one procedure per compartment can be billed and they do get paid

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