CPT Provides you An Assist on Multi-arthroscopy Encounters

In a particular situation, my orthopedist carried out a medial and lateral meniscectomy on a patient, and also performed a synovectomy in the patellofemoral compartment. Because the arthroscopic procedures were carried out in separate knee compartments, is it possible to code for their procedures or do I have to select one? Well, you should be able to report both procedures. You should report the following on the claim:

29880 (Arthroscopy, knee, surgical; with meniscectomy [medial AND lateral, including any meniscal shaving])

29875 (… synovectomy, limited [example, plica or shelf resection [separate procedure]]) for the synovectomy

modifier 59 (Distinct procedural service) added to 29875 to show that the synovectomy and meniscectomy were different services. Explanation: In case the payer challenges the appropriateness of this coding, note this guidance from the August 2001 CPT Assistant: Arthroscopic synovectomy is reported using 29875 and 29876. Limited synovectomy (29875) involves resection of the synovium and may cover partial resection of the plica of one knee compartment… 29875 is designated as a "separate procedure". Normally, codes with the 'separate procedure' designation would not be additionally reported when the procedure or service is carried out as an integral component of another procedure or service. But then when a procedure or service designated as a separate procedure is carried out independently or is thought of as unrelated or distinct from the other procedure(s) or service(s) provided at the time, then it would be proper to report the code in combination with the other procedure(s) or service(s). Modifier -59, Distinct Procedural Service should be added to the separate procedure code to indicate that the procedure was distinct from the overall procedure. For instance, if the knee arthroscopy with limited synovectomy were carried out in a different knee compartment than another knee procedure, modifier 59 would be added to code 29875 to show that a different compartment was involved. For more on this and for other medical coding updates regarding orthopedic coding, sign up for a one-stop medical coding guide like Supercoder.

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