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29876 & 29877

  1. Question 29876 & 29877
    Medical Coding Books
    Medial Compartment

    Lateral Compartment

    Patello-femoral Compartment

    Can anyone explain to me how this should be billed?


  2. Default
    You can only bill those codes once.

    29880 ...w/ menisectomy (medial and lateral to include any shaving)
    29876 ... synovectomy, major, 2 or more compartments
    29877 ....chrondroplasty or shaving and this code can not be billed with either one of those codes. Depedning on the insurance company you use G0289. You would need to check with your billing department or the carrier. Medicare and Medicaid for sure take the G0289.

    The Patello-femoral compartment is included with the medial/lateral depending on the port side.

    Hope this helps.

  3. #3
    I would bill as 29880 and G0289. You can try to bill 29875 for the pf compartment however I have seen that deny by a lot of payers. You can get G0289 paid as it is an add on code to 29880. Hope this helps.

  4. Default
    I thought that in order for G0289 to be used, it had to be in a totally separate compartment as other procedures. I am confused, I would have coded 29880, 29876[59], G0289, is this not appropriate?

  5. #5
    Doc is already doing work in the medial and lateral compartment so go with your menisectomy 29880 and bill for the work done in the separate compartment (pf) as a G0289. What would be your justification for 29876-59 in addition to 29880 and G0289? There is not a 4th compartment.

  6. Default
    So I see you can replace 29877 in the pf with G0289. I was suggesting bill for the 29876 in the same compartment. I am having trouble understanding why you cannot bill for the 29876 in the pf.

  7. #7
    Default G0289
    G0289 is "arthroscopy, knee,surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arhtroscopy in a different compartment of the same knee"

    It is in your HCPCS book.

    you cannot acheive 29876 with this surg...(as far as coding) 29876 is 2 or more compartments, but you cannot count medial or lateral because you are doing meniscectomy in those compartments and it is included. You can try billing the 29875 for the PF compartment but it may be denied becasue it is a "separate procedure" which typically means if you are doing anything else on same limb, site, then you cannot bill "separate procedure" and most payors almost automatically deny "separate procedures".

    It is not neccessarily that you cannot bill for is that you probably won't be paid for it(29875)
    Last edited by PLAIDMAN; 06-16-2011 at 03:27 PM.

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