One of the most popular minimally invasive treatments used to treat knee discomfort is knee arthroscopy. Every year, around 750,000 arthroscopic knee procedures are performed, costing a total of $4 billion.
Hence, your on-time payment collection is crucial because of the increased demand. CPT code 29881 can be used to bill this procedure. Since you are here to learn the specifics of this code’s reimbursement, let’s continue our exploration in this blog. You will gain all the knowledge necessary (from basic description to billing guidelines) to succeed in CPT code 29881 billing from this guide. Let’s get started.
CPT Code 29881 – Description
Physicians can use CPT code 29881 to bill their services of knee arthroscopy with meniscectomy. It is a minimally invasive surgical process. What happens during this process is that the physician examines the inside of the knee joint using an arthroscope, which is a thin, flexible tube-like instrument with a camera and light at one end. The physician then removes the meniscus from the medial or lateral compartment of the knee joint to repair it.
The physician may also reshape the articular cartilage that covers the bony surfaces in medial or lateral compartments by shaving or excising tissue from its surface.
This procedure is performed to reduce the knee pain, swelling, and limited movement caused by a torn meniscus or damaged cartilage.
Appropriate Use Cases for CPT Code 29881
Let’s find out the real-world applications of CPT code 29881 below.
Damaged Cartilage
Imagine a 24-year-old man met a road accident. This resulted in a serious injury to his left leg after falling off his bike. He immediately felt an intense pain in his knee accompanied by swelling. His MRI results show that the cartilage in his knee has sustained damage due to the fall. The orthopedic surgeon performs an arthroscopy with meniscectomy to repair the damaged knee joint. In this case, CPT code 29881 might be used to bill for the services provided.
Medial Meniscus Tear
Suppose a 20-year-old man regularly plays football. However, one day while playing a routine match, he suffered a severe knee injury. His test reports reveal that his internal cartilage is damaged. So, the physician decides to perform an arthroscopic meniscectomy on the medial compartment of the knee joint. He can apply CPT code 29881 to bill his services.
Lateral Meniscus Tear
A 45-year-old laborer fell at a construction site while at work. The orthopedic specialist orders several imaging tests to assess possible injuries. The imaging reveals that a tear is affecting the cartilage on the outside of the knee (lateral meniscus). Consequently, he performs an arthroscopic lateral meniscectomy. To bill for this procedure, the orthopedic surgeon may utilize CPT code 29881.
Modifiers to Append with CPT Code 29881
You can refer to the text below to find out the applicable modifiers with CPT code 29881.
Modifier 59
You can add modifier 59 to CPT code 29881 to indicate that the physician provided a separate service from the knee arthroscopy with meniscectomy on the same service date. Therefore, both procedures should be separately reimbursed.
Modifier RT
You must specify that the surgical procedure covered under CPT code 29881 was performed on the right knee by appending the modifier RT to the procedural code.
Modifier LT
Similar to RT, LT is also a laterality modifier. When the surgeon performs knee arthroscopy on the left knee, you report CPT code 29881 with modifier LT.
Reimbursement Guidelines for CPT Code 29881
The following are some points that you must keep in mind when reporting code 29881.
Ensure Appropriate Use of CPT code 29881
It is a well-known principle that billing a code requires a clear understanding of its description. It is crucial to note that the CPT code 29881 specifically pertains to a meniscectomy performed in either the medial or lateral compartment. If both the medial and lateral compartments are involved in the meniscectomy, this code cannot be used for billing. There exists a different code – CPT code 29880 – for billing a meniscectomy that includes both compartments.
Include Accurate Documentation
Your records serve two primary purposes. The first is to ensure payment from insurance payers, while the second is to demonstrate the medical necessity of the treatment. Thorough and precise documentation enables you to achieve both of these goals. Your documents must include several critical elements, which are:
- Day and place of the service.
- The patient’s symptoms with relevant ICD-10 codes.
- The approach used during the procedures.
- A mention of the meniscus that the surgeon removed (e.g., medial OR lateral, including any meniscal shaving).
- An indication of the compartment of the procedure (same or separate compartment).
- A documentation of all details of the examined compartments.
Pay Attention to the Global Period
You must be aware of the global period while billing for the surgical process. The global package results in a single payment for all care associated with a procedure within a specified timeframe. It includes the payment for pre-, intra-, and post-surgical services.
CPT code 29881 has a global period of 90 days. Therefore, you cannot bill separately for the follow-up appointments or related services during the global period. Otherwise, this may cause denials.
Final Thoughts on CPT Code 29881
Before we move to the end of this read, let’s just have a quick look at the key takeaways from this guide.
CPT code 29881 is associated with knee arthroscopy that includes a meniscectomy procedure. A physician may utilize this code for the removal of the medial or lateral meniscus in the knee joint. It is crucial to specify the side of the body where the services were rendered by using the modifier LT/RT, and to apply Modifier 59 if other separate services were provided on the same date. You must ensure the proper application of the code, along with the required documentation, and not bill related follow-up visits separately in the 90-day global period.
We hope that this guide provides you with all the essential information needed for billing knee arthroscopy procedures. However, if you require expert assistance, you can opt for orthopedic billing services to deal with complex billing challenges.
