Arthroscopic removal of foreign body
Proper coding arthroscopic removal of a loose or foreign body from the knee can be tricky. A lot depends on your payer, and whether other arthroscopic procedures are performed on the same knee during the same session, or not. An arthroscopic removal of loose or foreign body from the knee may be reported using:
- CPT(R) 29874, Arthroscopy, knee, surgical; for removal of loose body or foreign body (Eg: Osteochondritis dissecans fragmentation, chondral fragmentation) possibly with modifier 59 Distinct Procedural Service appended.
- HCPCS G0289, Arthroscopy, knee, surgical, or 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. Or
- Not at all as it is bundled to another procedure.
- G0289 is to be used when a procedure is performed in the lateral, medial, or patellar compartments, in addition to the main procedure. Be aware that the physician may not specifically document this information in the operative note.
- To support billing, surgeons need to document the full details involved in performing the chondroplasty procedure, not just state, “Chondroplasty performed.” Physicians’ offices likely know of this requirement, but do not practice it; therefore, this is an excellent educational opportunity for surgeons.
- According to a CMS memorandum, G0289is incidental and will not generate a separate APC payment for hospitals. G0289 is a packaged service under OPPS and the facility will not receive additional payments. However, additional money is paid for the professional fee when G0289 is billed.
- Modifiers -RT and -LT can be appended to indicate the side for each separate procedure. Cpt codes 29877 and 29876 have now been combined into code G0289.
- According to the CMS memorandum, it is inappropriate to assign and bill the following CPT codes with
- 29874, Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochrondritis dissecans fragmentation, chondral fragmentation).
- 29877, Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chrondroplasty) with other arthroscopic procedures on the same knee.