Coding for Arthroscopic Knee Surgery
Arthroscopy is a minimally invasive surgical procedure on a joint in which an examination and sometimes treatment of damage is performed using an arthroscope, an endoscope that is inserted into the joint through a small incision. Arthroscopic procedures can be performed durin…
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Arthroscopic surgical procedure converted to open procedure Z53. 33 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM Z53. 33 became effective on October 1, 2021.
Presence of artificial knee joint, bilateral The 2022 edition of ICD-10-CM Z96. 653 became effective on October 1, 2021. This is the American ICD-10-CM version of Z96.
M75. 101 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM M75. 101 became effective on October 1, 2021.
Knee arthroscopy is surgery that uses a tiny camera to look inside your knee. Small cuts are made to insert the camera and small surgical tools into your knee for the procedure. Knee arthroscopy is surgery that is done to check for problems, using a tiny camera to see inside your knee.
In ICD-10-PCS, arthroscopy goes to the root operation “inspection,” which is defined as visually and/or manually exploring a body part. Therefore, an arthroscopy of the right knee is classified to code 0SJC4ZZ, and arthroscopy of the left knee is classified to code 0SJD4ZZ.
Overview. Arthroscopy (ahr-THROS-kuh-pee) is a procedure for diagnosing and treating joint problems. A surgeon inserts a narrow tube attached to a fiber-optic video camera through a small incision — about the size of a buttonhole. The view inside your joint is transmitted to a high-definition video monitor.
Shoulder arthroscopy is surgery that uses a tiny camera called an arthroscope to examine or repair the tissues inside or around your shoulder joint. The arthroscope is inserted through a small cut (incision) in your skin.
Shoulder replacement removes damaged areas of bone and replaces them with parts made of metal and plastic (implants). This surgery is called shoulder arthroplasty (ARTH-row-plas-tee). The shoulder is a ball-and-socket joint.
Total shoulder replacement, also known as total shoulder arthroplasty, is the removal of portions of the shoulder joint, which are replaced with artificial implants to reduce pain and restore range of rotation and mobility. It is very successful for treating the severe pain and stiffness caused by end-stage arthritis.
The major difference between arthroscopic surgery and knee replacement surgery is that one surgery preserves your natural knee joint, while the other surgery replaces the knee joint with an artificial joint. Another important difference between arthroscopic surgery and knee replacement is the size of the incisions.
Overview. Arthroscopic meniscus repair is an outpatient surgical procedure to repair torn knee cartilage. The torn meniscus is repaired by a variety of minimally invasive techniques and requires postoperative protection to allow healing.
Knee replacement, also called knee arthroplasty or total knee replacement, is a surgical procedure to resurface a knee damaged by arthritis. Metal and plastic parts are used to cap the ends of the bones that form the knee joint, along with the kneecap.
Z96. 651 - Presence of right artificial knee joint. ICD-10-CM.
Presence of right artificial knee joint The 2022 edition of ICD-10-CM Z96. 651 became effective on October 1, 2021.
ICD-10 code Z96. 65 for Presence of artificial knee joint is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
Bilateral primary osteoarthritis of knee M17. 0 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM M17. 0 became effective on October 1, 2021.
Treatment can also occur through the arthroscope by creating additional small incisions and inserting instruments such as scissors, shavers, or lasers. Almost all arthoscopic procedures are done on an outpatient basis.
The fifth character identifies the approach. Arthroscopy would be considered percutaneous endoscopic, which is defined as entry, by puncture or minor incision, of instrumentation through the skin or mucous membrane and any other body layers necessary to reach and visualize the site of the procedure.
According to Coding Clinic, surgical approaches (eg, scopes) are not coded if a more definitive procedure is performed. Therefore, if a procedure was done via a scope, assign a code for the procedure ...
0RJJ4ZZ is a billable procedure code used to specify the performance of inspection of right shoulder joint, percutaneous endoscopic approach. The code is valid for the year 2021 for the submission of HIPAA-covered transactions.
The ICD-10 Procedure Coding System (ICD-10-PCS) is a catalog of procedural codes used by medical professionals for hospital inpatient healthcare settings. The Centers for Medicare and Medicaid Services (CMS) maintain the catalog in the U.S. releasing yearly updates.
Cutting through the skin or mucous membrane and any other body layers necessary to expose the site of the procedure
Entry, by puncture or minor incision, of instrumentation through the skin or mucous membrane and any other body layers necessary to reach the site of the procedure
Entry, by puncture or minor incision, of instrumentation through the skin or mucous membrane and any other body layers necessary to reach and visualize the site of the procedure
Procedures performed directly on the skin or mucous membrane and procedures performed indirectly by the application of external force through the skin or mucous membrane
An important HCPCS code is G0289, Arthroscopy, knee, surgical, for removal of loose body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee. This code is used for Medicare to report the procedure in that description, when performed in a separate compartment of the knee during the same operative session. It is not appropriate to use code 29877 even with a modifier.
“From a CPT® coding perspective, if debridement or shaving of articular cartilage and meniscectomy are performed in the same compartment of the knee, then only code 29881, Arthroscopy, knee, surgical; with meniscectomy (medial or lateral, including any meniscal shaving), should be reported. However, if debridement or shaving of articular cartilage is performed in one compartment of the knee and a meniscectomy is performed in a different compartment of the knee, then codes 29877, Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty), and 29881 should be reported.”
29880 Arthroscopy medial and lateral meniscectomy G0289 for the Arthroscopic removal of a loose body in a separate compartment 29880 is coded for the medial AND lateral meniscectomy Since the loose body removal was done in a separate compartment (patellofemoral), the G0289 is coded.
Slippery and flexible, hyaline (articular) cartilage within the knee joint allows, has less friction than two pieces of glass placed together. This allows the joint to move with minimal friction in a healthy knee. There are two primary types of cartilage in the knee:
29876 for the extensive synovectomy is the only code reported. G0289 for the loose body is NOT CODED because the synovectomy was done in the same compartment as the loose body and therefore it was not in a separate compartment and is not to be coded.
Diagnostic arthroscopies are used to examine and diagnose problems in the knee joint; surgical arthroscopies are used to treat diseased or damaged areas such as torn menisci, chondromalacia, or inflamed synovium.
Medicare reinforces its definition of G0289 in Chapter IV of the NCCI guidelines: “HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure.”.
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. During a meniscectomy, the surgeon removes a piece of the torn meniscus or the entire meniscus.
Although the National Correct Coding Initiative (NCCI) bundles 29877 Arthroscopy, knee, surgical debridement/shaving of articular cartilage (chondroplasty) and the meniscal repair codes, with a “0” modifier indicator, which typically means you cannot separately report the codes under any circumstance, Medicare allows providers to separately report chondroplasty with meniscal repairs if performed in a different compartment of the same knee. Medicare instructs coders to use HCPCS Level II code 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. Do not separately report chondroplasty if another surgery is performed in the same compartment.
Although knee arthroscopy is common, coding these surgical procedures can be complicated. Payment for knee arthroscopy hinges on proper coding, and proper coding relies on your knowledge of the code definitions and the differences between CPT® and Medicare guidelines. This article addresses both Medicare and private payer coding and guidelines for knee arthroscopy.
As such, do not report 29875 with other arthroscopic procedures in the same knee. You may only report 29875 when it’s the only arthroscopic procedure performed on the knee. Compartments are not recognized for the purpose of reporting this code.
According to CPT®, as long as pathologic synovial disease is present, you may use 29876 with another arthroscopic knee procedure, even if it occurs in the same compartment — excluding procedures for removal of loose/foreign body or chondroplasty.