CPT Coding Knee Arthroscopy

CPT codes 29866-29887 are used to report knee arthroscopy procedures.

HCPCS code 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, is also used in some instances for Medicare claims.

Considering that only one compartment of knee is involved, we see what codes can be coded and what are bundled together

CPT code 29875 limited synovectomy and or plica resection is bundled into CPT chondroplasty and CPT menisectomy codes 29877 and 29880. Hence if plica resection, which is part of synovium, and chondroplasy are performed in the same compartment at the same session, only chondroplasty should be reported. Similarly if limited synovectomy and menisectomy is done in the same compartment, only menisectomy code 29880-29881 should be reported.

Most of the the time synovectoy is performed for better visualization during arthroscopy as it obstructs the view of the physician and hence shoud not be coded as it is included in the procedure being done.

Major synovectomy is an extensive procedure and includes condroplasty.

Abrasion chondroplasty includes chondroplasy. Abrasion chondroplasty involves microfractures or drilling to the bone till bleeding for better regeneration.

Femoral notchplasty if performed alone is coded to 29999 unlisted arthroscopic code. Femoral notchplasty is included in chondroplasty so if chondroplasty is peformed it should not be reported seperately.

Femoral notchplasty is also included in anterior cruciate ligament reconstruction hence should not be coded seperately when ACL is performed.

CPT code for arthroscopic loose body removal should be coded only if no other procedure is performed in the same compartment of the knee. For loose bodies greater than 1 CM a seperate code can be used.

Use CPT code 29873 for Arthroscopic lateral release for patellar dislocations.

Knee Compartments:
From CPT coding prospective there are three knee compartments patellofemoral, medial, and lateral. Medical femoral condyle and lateral femoral condyle are part of medical and lateral compartments respectively.