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Orthopedic Coding Alert

Reader Questions:

Avoid 29877 for ACL Debridement

Question: Our surgeon performed an arthroscopic partial ACL debridement, partial medial meniscectomy and patellar chondroplasty. I plan to report 29881 and two units of 29877 because the ACL is in the lateral compartment and the patellar chondroplasty is in another compartment. Which modifiers should I append to the second unit of 29877?

Missouri Subscriber
Answer: CPT guidelines dictate that you should report 29877 (Arthroscopy, knee, surgical; debridement/shaving of articular cartilage [chondroplasty]) only once per knee per operative session, regardless of how many compartments the surgeon addresses. 

However, you should never report 29877 for ACL debridement, because 29877 describes debridement or shaving of articular cartilage, and the ACL is not
articular cartilage.

Therefore, you should report 29881 (Arthroscopy, knee, surgical; with meniscectomy [medial OR lateral, including any meniscal shaving]), and 29877 attached to modifier -59 (Distinct procedural service) for your surgeon's work.
If the surgeon performed the procedures on a Medicare patient, you should instead report 29881 and 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).

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