2 Knee Arthroscopy Myths You Need to Bust Right Now

coding for surgical knee arthroscopy

There are a lot of possible variations for knee arthroscopy services, so you’ve got to know where to go for help on coding them. Make sure your knee arthroscopy claims don’t fall victim to these two error-causing myths! Follow the guidance in the Correct Coding Initiative manual.

Myth: Report G0289 Along With 29880/29881 for Chondroplasty

Orthopedic coders should know the general rule that Medicare allows you to report a knee arthroscopy code together with FBR/chondroplasty code G0289 (Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee).

Exceptions: The CCI manual, chapter IV, section E.6, alerts you that there are limitations if you want to report G0289 with meniscectomy CPT® codes 29880 and 29881. The wording in the manual is confusing, so here’s the gist.

  • The code descriptors for 29880 and 29881 specify that those codes include “debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed.” So you should NOT separately report G0289 for debridement/shaving in conjunction with 29880 and 29881. That would be double dipping.
  • On the other hand, the code descriptors for 29880 and 29881 DO NOT reference removal of a loose or foreign body from a different knee compartment. Consequently, you may report G0289 for loose/foreign body removal services alongside 29880 and 29881.

Two reminders: Code G0289 is reportable only for services in a different knee compartment (not the compartment undergoing another surgical knee arthroscopy). And before reporting G0289, be sure to watch for CCI edits that you need to override with a modifier.

Myth: Add On a ‘Clean Up’ Knee Synovectomy Code

“A synovectomy to ‘clean up’ a joint on which another more extensive procedure is performed is not separately reportable,” the CCI manual states in chapter IV, section E.8. So when you’re reporting another arthroscopic knee procedure on the same knee, don’t also report 29875 (Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (separate procedure)).

Major synovectomy opportunity: Clean-up synovectomy may not be reportable, but don’t miss the CCI manual rule that allows reporting 29876 (Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments (eg, medial or lateral)).

You may report 29876 for medically necessary synovectomy along with another arthroscopic procedure on the same knee if documentation shows the synovectomy was in the two compartments in which the other procedure wasn’t performed.

Caution: The knee has three compartments, so if you report a two-compartment surgical service (like 29880 for medial and lateral meniscectomy), that leaves only one knee compartment not treated by the main service. You should not report 29876 for synovectomy in that case, the manual warns. You won’t be able to meet the 29876 requirement that the synovectomy must be in two compartments not involved in the other procedure.

What About You?

What reporting myths do you hear that you would like other coders to get the facts on?

About 

Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.

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