icd-9 code for arthroscopic knee procedure

Full Answer

What is the ICD 10 code for knee arthroplasty?

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. The fifth character identifies the approach. What is arthroplasty surgery?

What is the diagnosis code for total knee replacement?

What is the diagnosis code for total knee replacement?

• Index of External Causes of Injuries
• Approximate Synonyms
• Convert Y79.2 to ICD-9 Code
• Index of Internal Causes of Injuries Y79.1 was the previous code, while Y79.3 was the next code.

What is the diagnosis code for knee pain?

Pain in unspecified knee

• M25.569 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 M25.569 became effective on October 1, 2021.
• This is the American ICD-10-CM version of M25.569 - other international versions of ICD-10 M25.569 may differ.

What is the CPT code for Arthroscopy right knee?

An Arthroscopically aided ACL repair/reconstruction includes the following:

• Insertion of synthetic bone substitute bone matrix/methylmethacrylate
• Internal fixation of graft
• Notchplasty
• Insertion or placement of surgical drain
• Closure of wound and repair of tissues for initial surgical exposure. ...
• Harvesting of the graft (fascia, tendon or bone) even if performed through a separate incision

What is the ICD 10 code for right knee arthroscopy?

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.

What is icd9 code for knee surgery?

81.54 Total knee replacement - ICD-9-CM Vol. 3 Procedure Codes.

How do you code a knee arthroscopy?

According to CPT, code 29877 (Arthroscopy, knee, surgical; debridement/shaving of articular cartilage [chondroplasty]) should be reported to indicate the performance of an arthroscopic chondroplasty in the medial, lateral, and/or patellofemoral compartment(s).

What is the ICD 10 code for status post arthroscopy?

Encounter for other specified surgical aftercare The 2022 edition of ICD-10-CM Z48. 89 became effective on October 1, 2021. This is the American ICD-10-CM version of Z48.

What is the ICD 10 code for right total knee arthroplasty?

Z96. 651 - Presence of right artificial knee joint. ICD-10-CM.

What is the ICD 10 code for history of knee surgery?

653.

What is the CPT code for arthroscopy right knee?

Report CPT code 29877 (Arthroscopy, knee, surgical; debridement/shaving of articular cartilage [chrondroplasty]) for arthroscopic debridement with presentation of knee pain only, or arthroscopic debridement without lavage for patients with severe osteoarthritis.

What is the anesthesia code for a surgical arthroscopy of the knee?

Per the ASA CROSSWALK®, the anesthesia care may be best described with anesthesia CPT code 01402 - Anesthesia for open or surgical arthroscopic procedures on knee joint; total knee arthroplasty.

What is an arthroscopy procedure?

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.

What is diagnosis code Z98 89?

Other specified postprocedural statesICD-10 code Z98. 89 for Other specified postprocedural states is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .

What is the ICD-10 code for aftercare following orthopedic surgery?

ICD-10-CM Code for Encounter for other orthopedic aftercare Z47. 89.

What is the ICD-10 code for surgery?

Surgical procedure, unspecified as the cause of abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure. Y83. 9 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 Y83.

What is replaced in total knee replacement?

The procedure involves cutting away damaged bone and cartilage from your thighbone, shinbone and kneecap and replacing it with an artificial joint (prosthesis) made of metal alloys, high-grade plastics and polymers.

What is the ICD 9 code for hip pain?

ICD-9-CM 719.45 converts approximately to: 2022 ICD-10-CM M25. 559 Pain in unspecified hip.

What is the ICd 9 code for arthroscopy?

Arthroscopy is classified to ICD-9-CM subcategory 80.2. A fourth digit is required to identify the joint being scoped. A code from this subcategory is assigned when it is the only procedure performed (eg, diagnostic procedure). If a more definitive procedure is done at the same time, a code for the arthroscopic approach is not assigned. 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 (open) performed until specific codes for the arthroscopic approach are created, but do not assign a separate code for the scope ( AHA Coding Clinic for ICD-9-CM, 1993, first quarter, page 23).

What is the code for a ruptured meniscus?

Ruptured or detached meniscus goes to the same codes for tear of meniscus except that recurrent detachment of meniscus is classified to code 718.36, Recurrent dislocation of joint, lower leg.

What is the fifth character of an arthroscopy?

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.

How is an arthroscopy performed?

Arthroscopy is a minimally invasive procedure performed through a small incision by inserting a small camera hooked to a television monitor. It provides a clear view inside the joint so the surgeon can definitively diagnose the condition. 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.

What is the fifth digit of a ligament?

A fifth digit is required to identify the ligament involved. Tearing of knee cartilage or meniscus: The wedge-shaped pieces of cartilage in the knee joint are called meniscus and act as shock absorbers. They can tear in different ways and are classified by how they look and where the tear occurs.

What is a sprain in the knee?

Sprain: This occurs when one or more ligaments in the knee is suddenly stretched or torn. There are four knee ligaments: anterior cruciate, posterior cruciate, medial collateral, and lateral collateral.

Can you code a surgical approach?

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 ...

What is the code for arthroscopy of the knee?

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 patient’s 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 at modifier.

What is the purpose of a knee arthroscopy?

Arthroscopy: Knee arthroscopy allows the physician to visualize the joint space of the knee using a fiberoptic en doscope. (An endoscope is basically a long tube with a lens at each end. Endoscopes used to visualize joint spaces are call arthroscopes). This Technology also allows the physician to perform arthroscopic surgery using.

What is the code for a meniscal shaving?

HCPCS code G0289 may be reported in addition to CPT® code 29880 , Arthroscopy, knee, surgical; with meniscectomy (media AND lateral, including any meniscal shaving) or C PT® code 29881 , Arthroscopy, knee, surgical; with meniscectomy (medial or lateral, including any meniscal shaving)if performed in a separate compartment.

What is the code for shaving of articular cartilage?

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.

What is the CPT code for a meniscectomy?

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. (CPT® Assistant April 2005; page 14)

When both a diagnostic and surgical arthroscopy is performed, is the diagnostic arthroscopy an inclusive component?

When both a diagnostic and surgical arthroscopy is performed, the diagnostic arthroscopy is an inclusive component of the surgical arthroscopy and would not be reported separately. (CPT® Assistant August 2001; page 5)

How many incisions are needed for knee surgery?

procedure. Arthroscopic knee surgery usually involved at least two incisions. The first incision is made on the lateral side of the patellar incision-this is where the arthroscope is inserted. Additional incisions are made, one on the medial side of the patellar tendon and other as needed, for the insertion of surgical instruments.

What is the CPT code for a medial meniscal posterior horn tear?

Tricompartmental synovectomy includes the posteromedial and posterolateral portions of the joint accessed through posterior portals. The CPT codes that should be reported are 29876 and 29881.

What is the code for a synovectomy?

The AAOS has previously described common diagnoses that support the medical necessity for major arthroscopic synovectomy in two or more compartments (code 29876). This includes, but is not limited to, the following:

What is the CPT code for medial compartment synovectomy?

The surgeon performs a medial meniscectomy and medial compartment synovectomy. The CPT code that should be reported is 29881.

What is CPT code 29875?

CPT code 29875, limited synovectomy, is described as a “separate procedure.” This means that the work associated with this procedure is inclusive to more extensive procedures performed in the same anatomic site (the knee) and is not separately reportable. This code should only be reported if it is the only procedure performed; separate compartment rules do not apply.

What is an indication for surgery?

Document an “Indication for Surgery” paragraph that includes past medical conditions or injuries, radiologic findings, the acute nature of injury, or the failure of conservative therapy.

Can a surgeon report a medial synovectomy?

For example, a surgeon may document performance of a medial meniscectomy and a tricompartmental synovectomy. Simple documentation, however, does not automatically allow reporting of both the major synovectomy code 29876 and the meniscectomy code 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) to payers.

What is the HCPCS code for knee surgery?

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.

What is the code for a meniscectomy?

“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.”

What is ACL repair?

29888 – ACL Repair 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

What type of cartilage is used in the knee?

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:

Is G0289 a synovectomy?

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.

What is the code for a knee arthroscopic procedure?

Code 29884 is considered to be included in any other major arthroscopic procedure performed in the knee, regardless of whether it is performed in a separate compartment. When synthetic plugs are used for osteochondral grafting of the knee (i.e., mosaicplasty), 29867 Arthroscopy, knee, surgical; osteochondral allograft (eg, ...

What are the codes for shoulder arthroscopy?

Shoulder arthroscopy codes encompass two joints in the shoulder area: the glenohumeral joint (typically called the shoulder joint) and the acromioclavicular joint. The acromioclavicular joint is the smaller of the two and there are arthroscopy codes specific to it; excision of the distal clavicle, 29824 Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (Mumford procedure) and decompression of the subacromial space, 29826 Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with or without coracoacromial release, which includes partial excision of the acromion or acromioplasty.#N#Arthroscopic debridement of the labrum and of the undersurface of the rotator cuff (29822 Arthroscopy, shoulder, surgical; debridement, limited) may be reported separately when performed with subacromial decompression (29826), according to the May 2001 CPT® Assistant. Per the same edition, Subacromial decompression includes acromioplasty, arch decompression, excision of bursa, and coracoacromial ligament release.#N#Open procedures 23410, 23412, and 23420 differentiate between whether the tear is acute or chronic or how many tendons are repaired. The arthroscopic code for rotator cuff repair (29827 Arthroscopy, shoulder, surgical; with rotator cuff repair) makes no such distinctions, and can be reported whether the tear is acute or chronic; whether one, two or three tendons are repaired, or; whether one or more portals is required to repair the cuff (February 2008 CPT® Assistant).#N#Often the surgeon will perform a biceps tenotomy (i.e., tendon release) via arthroscopy, and then perform a tenodesis via an open procedure. In such cases, the code for open biceps tenodesis (23430 Tenodesis of long tendon of biceps) is most appropriate. Only assign the code for arthroscopic biceps when the tenodesis portion of the procedure is performed via arthroscope.#N#Arthroscopic capsular shrinkage (i.e., thermal capsulorrhaphy) is at times used to treat joint instability. For payers recognizing HCPCS Level II S codes, S2300 Arthroscopy, shoulder, surgical; with thermally-induced capsulorrhaphy is appropriate for these procedures. For payers who do not recognize S codes, CPT®29999 Unlisted procedure, arthroscopy is appropriate. This procedure generally is considered investigational and not payable by many payers.

What is the compartment code for abrasion arthroplasty?

The compartment coding concept is important for coding arthroscopic procedures in the knee accurately.#N#The code for arthroscopic abrasion arthroplasty, multiple drilling and/or microfracture (29879 Arthroscopy, knee, surg ical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture) may be coded per compartment so you should code microfracture of both medial and lateral femoral condyles as 29879, 29879-59 Distinct procedural service.#N#As the descriptor states, chondroplasty (29877 Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)) is included in 29879 when chondroplasty is performed in the same compartment. However, a chondroplasty performed in a separate compartment may be reported separately to 29877-59 (August 2001 CPT® Assistant).#N#For Medicare, 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 may be reported once for a chondroplasty and/or loose body removal performed in each compartment where it is the only procedure performed. In contrast to 29879, report code 29877 only once per knee, regardless of the number of compartments in which it is performed (December 2005 CPT® Assistant).#N#An often overlooked code is 29884 Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure), which may be assigned for excision of fibrosis/adhesions/scar due to previous procedures or injuries. Debridement of cyclops lesions after total knee replacement (s) is a common condition for which arthroscopic lysis of adhesions is performed. Code 29884 is considered to be included in any other major arthroscopic procedure performed in the knee, regardless of whether it is performed in a separate compartment.#N#When synthetic plugs are used for osteochondral grafting of the knee (i.e., mosaicplasty), 29867 Arthroscopy, knee, surgical; osteochondral allograft (eg, mosaicplasty) may be assigned, even though the descriptor refers to allograft, per the December 2008 CPT® Assistant. The same, however, does not apply for the ankle. Rather than assign code 29892 Arthroscopically aided repair of large osteochondritis dissecans lesion, talar dome fracture, or tibial plafond fracture, with or without internal fixation (includes arthroscopy) for placement of synthetic material, report unlisted code 28899 Unlisted procedure, foot or toes.

What is the code for a bicep tenotomy?

Often the surgeon will perform a biceps tenotomy (i.e., tendon release) via arthroscopy, and then perform a tenodesis via an open procedure. In such cases, the code for open biceps tenodesis (23430 Tenodesis of long tendon of biceps) is most appropriate.

What is an arthroscopy?

Arthroscopy refers to less invasive procedures in which an endoscope is placed within the joint for the performance of diagnostic and therapeutic procedures. As technology advances, procedures previously performed through large incisions are now performed arthroscopically. To accommodate this emerging technology, new arthroscopy, ...

Is 29848 an arthroscopy?

Note: Two codes in this section (29848 Endoscopy, wrist, surgical, with release of transverse carpal ligament and 29893 Endoscopic plantar fasciotomy) are not technically arthroscopies (that is, they are not endoscopies within a joint), but rather are musculoskeletal endoscopies.

What are the three compartments of the knee?

In arthroscopic knee surgery, the knee is subdivided into three compartments: medial, lateral, and patellofemoral.

What is modifier 59?

Modifier 59 is defined as “Under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-E/M services performed on the same day. Modifier 59 is used to identify procedures/services, other than E/M services, that are not normally reported together, but are appropriate under the circumstances. Documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual.

What is the CPT code for a disputed date of service?

On the disputed date of service, the requestor billed CPT codes 29881-LT and 29875-LT-59.

Is knee arthroscopy covered by Medicare?

Yes, knee arthroscopy is covered under Medicare and Medicaid. Your provider may need to establish medical necessity or pre-certification before you receive treatment.

Do you need to get precertification for knee arthroscopy?

You should always ask and then confirm that your provider is going to obtain precertification for your knee arthroscopy before you receive treatment. If your provider does not obtain pre-certification prior to your knee arthroscopy, you will need to call the health plan and request pre-certification yourself.

Is 29875 a separate procedure?

A “separate procedure” should not be reported when performed along with another procedure in an anatomically related region through the same skin incision or orifice, or surgical approach.”. The Division finds that because code 29875 has the parenthetical statement “separate procedure” the CCI policyapplies. Both procedures code 29881 and 29875 ...

Does insurance cover knee arthroscopy?

Yes, knee arthroscopy is usually covered by health insurance. Always check with your insurer to make sure a procedure is covered before seeking treatment. Your insurer may require pre-certification prior to agreeing to cover your knee arthroscopy.