JULY 2014

Arthroscopic Knee Synovectomy

I’ve always wondered about the correct reporting method for arthroscopic knee synovectomy procedures because there have been varying opinions on coding and each time we have queried the AMA for clarification on this issue we have gotten different responses - that is, up until recently. 

Currently the AMA has indicated that they agree with the AAOS Now article (Jan. 2013) stating that this is the most current coding information available and would supersede any previously published advice.  In case you haven’t seen the article here are the coding recommendations.

  • Synovitis must be pathological (red, swollen, inflamed) – simply removing synovial fibrillation to clean up the joint or for visualization would not constitute reporting codes 29875 or 29876.
  • CPT code 29875 is designated as a “separate procedure” therefore this code is reported by anatomical site (knee) - SEPARATE COMPARTMENT RULES DO NOT APPLY – so the synovectomy procedure would not be reported with a more extensive procedure in the same knee.
    For example: Physician performs medial compartment meniscectomy and lateral compartment synovectomy – based on AMA and AAOS coding recommendations the coder should only report 29881 (separate compartment rules do not apply and synovectomy was performed in addition to a more extensive procedure).
  • Code 29875 would be reported when it is the only procedure performed during a surgical encounter. 
  • CPT code 29876 represents a major synovectomy that is performed in two or more compartments of the knee, however many op notes will just document the fact that a tricompartmental synovectomy was performed, so be cautious and make sure you also have medical necessity established through the physician’s dictation before reporting code 29876.
  • When reporting code 29876 it does not matter if another procedure was performed in the same compartment.  For example:  Physician performs meniscectomy in medial and lateral compartments with synovectomy in the medial and lateral compartment (or even tricompartmental synovectomy), as long as there was pathological synovitis present the AMA and AAOS coding recommendation is to report 29880 and 29876. 

Keep in mind that for Medicare patients or those carriers following CCI edit guidelines – 29876 bundles into 29880.







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