Basics about CPT code 29881, 29880 and 29877

For Medicare patients, the major arthroscopic knee procedures are assign with standard arthroscopy codes (29870-29887). However, we have to use a separate HCPCS code G0289  for procedures like chondroplasty and/or loose foreign body removal when performed on different compartment on same knee. Meniscectomy (CPT code 29881) and Chondroplasty (CPT code 29877) should be coded carefully when the treatment in performed is same or different compartment of same knee.

As we know we have separate CPT codes for removal of loose body or foreign body 29874 and chondroplasty 29877, but these procedure codes are inclusive with major procedure codes when performed on same compartment. Hence, CMS will not allow coding CPT code 29874 and 29877 along with other major arthroscopic procedures CPT code 29881 or 29880 on same knee and same compartment.

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Knee arthroscopic Procedures used with code G0289

There are very few commonly used major arthroscopic procedures, which are extensively used. There are few codes, which are included in the major arthroscopic procedure when performed in same knee and same compartment. Hence, it is very important to know about the full description about these procedure codes.

29874 – Arthroscopy, knee, surgical; for removal of loose body or foreign body (eg, osteochondritis dissecans fragmentation, chondral fragmentation)

29875- Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (separate procedure)

29876- Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (eg, medial or lateral)

29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)

29880- Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed

29881- Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed

29883  Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)

29884  Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)

29885  Arthroscopy, knee, surgical; drilling for osteochondritis dissecans with bone grafting, with or without internal fixation (including debridement of base of lesion)

29886  Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion

29887  Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion with internal fixation

Above you can see the full description for CPT code 29874 and 29877. So, for Medicare patient we use completely new HCPCS or G code G0289 for coding removal of loose body or foreign body or chondroplasty in different compartment of same knee. This code is an add-on code and should not used primary in any cases.

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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Examples for Coding Knee arthroscopy procedures

The coding guidelines for knee arthroscopy differ for same and different compartment of the knee. 

When multiple surgical procedures are performed in the same compartment of the knee, only the most complex procedure is reported. Do remember when both a diagnostic and surgical arthroscopy are performed, the diagnostic arthroscopy (29870) is an inclusive component of the surgical arthroscopy and would not be reported separately.

Example 1: Both a meniscectomy (CPT code 29881) and debridement of loose cartilage (CPT code 29877) are performed in the medial compartment of the right knee. Only CPT code 29881 should be reported.

Procedures performed in a different compartment of the same knee should be coded with the modifier -59 appended.

Example 2: A meniscectomy is performed in the medial compartment and a major synovectomy is performed in the medial and lateral compartments of the same knee.  CPT Code 29881 would be reported for the meniscectomy in addition to 29876 for the synovectomy. Modifier 59 is appended to CPT code 29876 to identify it as a distinct procedure performed in a different compartment.

Do and Don’t about CPT code G0289

Do not code G0289 when the when the procedure is performed for removal of loose body or foreign body or chondroplasty is done on same compartment of knee. It should be used only for Medicare patient and should be used with other major arthroscopic procedures performed on same knee in different compartment.

Never use G0289 as primary code. It is an add-on code and hence should not be used along with other major arthroscopic knee procedures.

G0289 is reported only once for each additional compartment operated on, even if more than one procedure is performed. G0289 should be reported only when the physician spends at least 15 minutes in the additional compartment performing this procedure. It should not be reported if the reason for performing the procedure is due to the problem caused by the arthroscopic procedure itself.

If a knee arthroscopy for removal of loose or foreign bodies is performed in the same knee compartment as procedures described by codes 29875-29881, code 29874 should not be reported separately. It is considered to be an inclusive component of code 29875-29881.

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, but ideally, this is the best location