Arthroscopic surgery makes up a major number of surgical cases in Orthopaedic Surgery. Because insurance companies spend a large amount of reimbursement on these common procedures, the guidelines and policies are ever-changing to meet the changes in the actual procedures themselves. We will discuss the current guidelines and policies from CPT®, AMA, AAOS, CMS, and even commercial carriers like Aetna.

1. Current Trends in Arthroscopic
Surgery
Lynn M,.Anderanin, CPC, CPMA,
CPPM, CPC-I, COSC
1

2. Disclaimer
Lynn M. Anderanin, CPC. CPMA, CPPM, CPC-I, COSC has produced this
material as an informational reference for providers furnishing service in
orthopaedics and other specialties performing these services and make no
representation, warranty, or guarantee that this compilation of
information is error-free and will bear no responsibility or liability for the
results or consequences of the use of this material. Although every
reasonable effort has been made to assure the accuracy of the
information within these pages at the time of publication, there is not
guarantee against changes. Any regulations, policies and/or guidelines
cited in this publication are subject to change without further notice.
2

3. Agenda
• Hip Arthroscopy
• Knee Arthroscopy
• Shoulder Arthroscopy
• New Procedures
• Commercial Insurance Policies
3

4. Hip Arthroscopy
• 29862- Arthroscopy, hip, surgical; with
debridement/shaving of articular cartilage
(chondroplasty), abrasion arthroplasty, and/or
resection of labrum
• 29863- Arthroscopy, hip, surgical; with
synovectomy
4

5. Hip Arthroscopy
• 29914- Arthroscopy, hip, surgical; with
femoroplasty (ie, treatment of cam lesion)
• 29915- Arthroscopy, hip, surgical; with
acetabuloplasty (ie, treatment of pincer
lesion)
• 29916- Arthroscopy, hip, surgical; with labral
repair
5

6. Non-payable Code Combinations
29914 29915 29916
29914 -- Yes Yes
29915 Yes -- No
29916 Yes No --
29862 No No No
29863 No No No
6

7. Unlisted Arthroscopic Hip Procedures
• IIliopsoas Tendon Release
• Gluteus Repair
• Trochanteric Bursectomy
• Piriformis Release
• Quadratus Femoris Release
• Fixation of bone fragment (utilizing screws)
7

8. Arthroscopic Knee Codes
29866-Osteochondral autograft
29867-Osteochondral allograft
29868-Meniscal transplant
29870-Diagnostic
29871-Lavage and drainage for infection
29873-Lateral release
29875-29876-Synovectomy
8

9. Arthroscopic Knee Codes
29877-Debridement/chondroplasty
29879-Abrasion arthroplasty
29880-Meniscectomy, medial and lateral
29881-Meniscectomy, medial or lateral
29882-Meniscus repair, medial or lateral
29883-Meniscus repair, medial and lateral
29884-Lysis of adhesions
9

10. Arthroscopic Knee Codes
29885-29887-Osteochondritis dissecans
29888-ACL repair
29889-PCL repair
10

11. • https://www.cms.gov/Medicare/Coding/NationalCorrectCodI
nitEd/index.html?redirect=/nationalcorrectcodinited/
NCCI Policy Manual
11

12. Policy Manual
• Introduction
• General Coding Policies
• List of Acronyms
• CPT® specific guidelines by code range
Example
CHAPTER IV SURGERY: MUSCULOSKELETAL
SYSTEM CPT® CODES 20000-29999
12