Results 1 to 10 of 10

29877 and 29873

  1. #1
    Default 29877 and 29873
    Medical Coding Books
    Would anyone know if a chondroplasty 29877 is bundled with a lateral release
    29873. I've checked 2 resources ( code x and coding companion), one does not state that they are bundled and the other does.

    Thanks

  2. #2
    Location
    Duluth, Minnesota
    Posts
    1,133
    Default
    per CCI edits - yes, 29877 is bundled with 29873 and cannot be billed separately. Code only the 29873.
    {that's my opinion on the posted matter}
    Donna, CPC, CPC-H

  3. #3
    Location
    ENGLEWOOD/DENVER
    Posts
    2,338
    Default
    I disagree with Donna as the AMA has documentation that supports the use of the -59 modifier.

    If your documentation clearly supports that you are in a different compartment (either medial or patellofemoral), it is codeable with a 59 modifier. If the chondroplasty was performed in the lateral compartment you will not be able to code it.

    I DO have documentation to support the above statement as well and will be happy to repost it or you may find it in other threads under the orthopedic section.

    Hope this helps
    Mary
    Last edited by mbort; 09-08-2008 at 03:08 PM. Reason: added info

  4. #4
    Location
    north seattle wa
    Posts
    103
    Default
    Check code G0289. Medicare (and some otheres) will accept this for procedures done on a different compartment of the knee. We use the 29877-59 for the others, as long as it performed on a different compartment of the knee, carrier preference for reporting.

  5. #5
    Location
    ENGLEWOOD/DENVER
    Posts
    2,338
    Default
    and agree with Wendy that if this is a Medicare patient, you would have to use the G0289 per Medicare guidelines.

  6. #6
    Location
    Duluth, Minnesota
    Posts
    1,133
    Default
    hmm...so either CCI Edits is incorrect or payers are paying incorrectly? I don't know, I tend to follow CCI Edits, they haven't lead me wrong yet
    Donna, CPC, CPC-H

  7. #7
    Default
    Thanks Everyone

  8. #8
    Location
    ENGLEWOOD/DENVER
    Posts
    2,338
    Default
    Quote Originally Posted by dmaec View Post
    hmm...so either CCI Edits is incorrect or payers are paying incorrectly? I don't know, I tend to follow CCI Edits, they haven't lead me wrong yet
    Please keep in mind that the CCi edits are provided by Medicare. If you are familiar with orthopedics, then you are aware that the 29877 issue has been ongoing for close to 10 years now. Medicare has their own set of guidelines for the 29877. As you can see in the CCI edits the 29877 bundles with EVERY knee scope procedure. So IF this is a medicare patient then yes it does bundle but then you follow their guidelines that tell you to use G0289 for reporting purposes of the 29877.

    If your company follows STRICLY Medicare guidelines then you would use the G0289.

    However if not, and this is not a Medicare patient then you follow the AMA guidelines for reporting of the 29877.

    Hope this helps clarify my reasoning. If you would like the CPT assistant comments on this I will be happy to send them to you or I have posted them in the orthopedic forum previously.

    Mary

  9. #9
    Default
    Quote Originally Posted by mbort View Post
    I disagree with Donna as the AMA has documentation that supports the use of the -59 modifier.

    If your documentation clearly supports that you are in a different compartment (either medial or patellofemoral), it is codeable with a 59 modifier. If the chondroplasty was performed in the lateral compartment you will not be able to code it.

    I DO have documentation to support the above statement as well and will be happy to repost it or you may find it in other threads under the orthopedic section.

    Hope this helps
    Mary
    Can you share that documentation? I have a BCBS patient that had lateral release and chondroplasty of the inferior pole of the patella. I would like to be able to bill for both 29877 and 29873 because of being in two different compartments.

  10. #10
    Default
    Quote Originally Posted by JillSmithers View Post
    Can you share that documentation? I have a BCBS patient that had lateral release and chondroplasty of the inferior pole of the patella. I would like to be able to bill for both 29877 and 29873 because of being in two different compartments.
    I thought the lateral release is only performed in the patellar compartment, and since your chondroplasty is also performed in the same compartment, it does not qualify for a 59 modifier?

    But can someone provide documentation? I have always seen the column 2 for the 29877 with 29873, and never given it a second look on NCCI. Nor have I considered the G0289. Is this a physician CMS billing only or are ASC billing applicable as well?
    Last edited by C.Lam; 10-15-2014 at 08:25 AM.

Similar Threads

  1. 29877 and?
    By MELJNBBRB in forum Orthopaedics
    Replies: 2
    Last Post: 11-07-2014, 09:04 AM
  2. 29873 and 27422
    By trose45116 in forum Outpatient Facilities
    Replies: 1
    Last Post: 03-09-2012, 01:41 PM
  3. 29877 - this even payable
    By ChelseaNicole in forum Orthopaedics
    Replies: 1
    Last Post: 02-28-2012, 12:46 PM
  4. help with 29877
    By BFAITHFUL in forum Outpatient Facilities
    Replies: 6
    Last Post: 06-22-2009, 09:14 AM
  5. Knee lateral release 29873
    By Alta in forum Orthopaedics
    Replies: 4
    Last Post: 01-21-2009, 09:20 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.