How To Use CPT Code 29870

CPT 29870 is a diagnostic arthroscopy procedure for the knee, which may include a synovial biopsy. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 29870.

1. What is CPT 29870?

CPT 29870 is a diagnostic arthroscopy procedure performed on the knee joint, which may also include a synovial biopsy. This procedure is used to examine the inside of the knee joint, assess the causes of pain and limited movement, and potentially obtain a sample of the synovial tissue for further analysis and diagnosis.

2. 29870 CPT code description

The official description of CPT code 29870 is: “Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)”.

3. Procedure

1. The patient is prepped and anesthetized.
2. Small incisions are made in the knee area.
3. The arthroscope is inserted through one of the incisions into the knee joint.
4. Saline solution is instilled to expand the area around the knee joint.
5. The entire joint area is viewed using the camera of the scope.
6. If necessary, additional instruments are inserted to take a biopsy of the synovial tissue and submit it for analysis.
7. The ligaments and other structures in the knee are inspected.
8. The area is irrigated, checked for bleeding, and instruments are removed.
9. The incisions are closed.

4. Qualifying circumstances

Patients who are eligible to receive CPT 29870 services are those experiencing knee pain, limited movement, or other symptoms that may indicate a need for diagnostic arthroscopy. This procedure may be performed on patients with a history of knee injuries, chronic knee conditions, or those who have not responded to conservative treatments such as physical therapy or medication. A thorough evaluation of the patient’s medical history, symptoms, and physical examination findings should be conducted before determining if CPT 29870 is appropriate.

5. When to use CPT code 29870

CPT code 29870 should be used when a diagnostic arthroscopy of the knee is performed to assess the causes of pain and limited movement, and potentially obtain a synovial biopsy for further analysis. This code is appropriate for patients who have not responded to conservative treatments and require a more in-depth examination of the knee joint to determine the underlying cause of their symptoms.

6. Documentation requirements

Documentation supporting a claim for CPT 29870 should include a detailed medical history, physical examination findings, and any relevant imaging studies. The operative report should describe the specific steps of the procedure, including the insertion of the arthroscope, visualization of the joint, any biopsies taken, and the closure of the incisions. Additionally, any complications or additional procedures performed during the arthroscopy should be documented. The patient’s response to the procedure and any follow-up care or recommendations should also be included in the medical record.

7. Billing guidelines

When billing for CPT 29870, it is important to follow the appropriate guidelines and rules. Ensure that the patient meets the qualifying circumstances for the procedure and that the documentation supports the claim. Use the appropriate modifiers, such as RT (Right side) and LT (Left side), to identify the specific anatomical site. If a diagnostic arthroscopy leads to an open repair of a previously unknown condition, both the open repair and the diagnostic arthroscopy can be reported by appending the 59 modifier (Distinct procedural service) to the diagnostic arthroscopy code.

8. Historical information

CPT 29870 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Similar codes to CPT 29870

Five similar codes to CPT 29870 include:

• CPT 29871: Arthroscopy, knee, surgical; with synovectomy, limited (eg, plica or shelf resection) (separate procedure)
• CPT 29873: Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed
• CPT 29874: Arthroscopy, knee, surgical; for removal of loose body or foreign body (eg, osteochondritis dissecans fragmentation, chondral fragmentation)
• CPT 29875: Arthroscopy, knee, surgical; with synovectomy, major, 2 or more compartments (separate procedure)
• CPT 29876: Arthroscopy, knee, surgical; with removal of single or multiple loose bodies, 5 mm or larger

These codes differ from CPT 29870 in the specific surgical procedures performed during the arthroscopy, such as synovectomy, meniscectomy, removal of loose bodies, or foreign bodies.

10. Examples

1. A patient with chronic knee pain and limited range of motion undergoes a diagnostic arthroscopy (CPT 29870) to assess the cause of their symptoms.
2. A patient with a history of knee injuries experiences persistent pain and swelling, leading to a diagnostic arthroscopy (CPT 29870) with synovial biopsy.
3. A patient with suspected meniscal damage undergoes a diagnostic arthroscopy (CPT 29870) to determine the extent of the injury and plan for potential surgical intervention.
4. A patient with unexplained knee pain and stiffness undergoes a diagnostic arthroscopy (CPT 29870) to rule out inflammatory conditions or other underlying causes.
5. A patient with a history of knee surgery experiences recurrent pain and instability, leading to a diagnostic arthroscopy (CPT 29870) to assess the integrity of the surgical repair.
6. A patient with suspected ligament damage undergoes a diagnostic arthroscopy (CPT 29870) to evaluate the need for surgical intervention.
7. A patient with a history of rheumatoid arthritis experiences worsening knee pain and limited mobility, leading to a diagnostic arthroscopy (CPT 29870) with synovial biopsy to assess disease progression.
8. A patient with a suspected cartilage defect undergoes a diagnostic arthroscopy (CPT 29870) to determine the extent of the damage and plan for potential surgical repair.
9. A patient with a history of knee dislocation experiences persistent pain and instability, leading to a diagnostic arthroscopy (CPT 29870) to assess the integrity of the joint structures.
10. A patient with unexplained knee swelling and limited range of motion undergoes a diagnostic arthroscopy (CPT 29870) to rule out infection or other underlying causes.