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29876 with 29881

Kerry Posted Thu 28th of January, 2016 11:54:14 AM

Doctor did a medial meniscectomy, but also did the following:
Diagnostic arthroscopy demonstrated diffuse synovitis to the suprapatellar pouch and the medial and lateral gutters.

Next, attention was turned to a symptomatic medial plica band, which showed diffuse synovitis, tightness, and irritation of the medial femoral condyle. The plica band was resected with 4.5-mm shaver. Pictures were obtained. Next, the loose body was able to be removed from the lateral gutter with a 4.5-mm shaver. Following this, the suprapatellar pouch was debrided of synovitis.

Not sure how to code this...i know the plica band is a separate procedure, so 29875 cannot be billed, so I feel the plica band resection is out and that leaves me with synovectomy of the suprapatellar pouch. Just not sure how to go about coding this.

SuperCoder Answered Fri 29th of January, 2016 08:02:21 AM

If doctor has performed medial meniscectomy, then all other procedures like resection of plica band or synovectomy of the suprapatellar pouch are included or bundled in the main procedure performed (medial meniscectomy).

Further to give more clarity on this scenario, Cpt code 29875 is included in the main procedure of the same knee, if performed in the different compartment also. I this case the Synovectomy is happening in two compartments 1. Medial 2. Patellofemoral.
Medial Synovectomy is included in the medial menisectomy and petelofemoral Synovectomy cannot be billed as the single compartment Synovectomy (29875) is a separate procedure and cannot be billed when some other procedure is performed in the same compartment or different compartments of the same knee.

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