Lisa Posted Fri 07th of October, 2016 17:33:10 PM
Is it appropriate to code a left knee diagnostic arthroscopy with an open repair of left medial patellofemoral ligament? CCI bundles 29870 with 27420, but the scope was lateral and the open repair was anterior.
SuperCoder Answered Mon 10th of October, 2016 03:24:32 AM
As per NCCI 2016, If an arthroscopy is performed as a “scout” procedure to assess the surgical field or extent of disease, it is not separately reportable. If the findings of a diagnostic arthroscopy lead to the decision to perform an open procedure, the diagnostic arthroscopy may be separately reportable along with open procedure. Modifier 58 may be reported to indicate that the diagnostic arthroscopy and non-arthroscopic therapeutic procedures were staged or planned procedures. The medical record must indicate the medical necessity for the diagnostic arthroscopy. Append modifier 59 to CPT code 29870 as well to rule out bundling issues.
NOTE: If an arthroscopic procedure is converted to an open procedure, only the open procedure may be reported. Neither a surgical arthroscopy nor a diagnostic arthroscopy code should be reported with the open procedure code when a surgical arthroscopic procedure is converted to an open procedure.