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Current trends in arthroscopic surgery

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.

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Current trends in arthroscopic surgery

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

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