How To Use CPT Code 29875

CPT 29875 is a surgical code for arthroscopic knee synovectomy, specifically limited synovectomy such as plica or shelf resection. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 29875.

1. What is CPT 29875?

CPT 29875 is a surgical code used to describe an arthroscopic knee synovectomy procedure, specifically limited synovectomy such as plica or shelf resection. This procedure involves the removal of inflamed or damaged synovial tissue in the knee joint to alleviate pain and improve joint mobility.

2. 29875 CPT code description

The official description of CPT code 29875 is: “Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (separate procedure)”.

3. Procedure

  1. The patient is appropriately 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 knee joint area is viewed using the camera of the scope.
  6. Additional instruments are inserted to excise the inflamed or damaged fold of synovial membrane called the medial plica or medial shelf.
  7. The area is irrigated and checked for bleeding.
  8. Any instruments are removed, and the incisions are closed.

4. Qualifying circumstances

Patients eligible to receive CPT code 29875 services are those experiencing pain, swelling, or limited mobility in the knee joint due to inflamed or damaged synovial tissue, such as the medial plica or medial shelf. This procedure is typically recommended when conservative treatments, such as physical therapy, medications, or injections, have not provided sufficient relief.

5. When to use CPT code 29875

It is appropriate to bill the 29875 CPT code when a provider performs a limited arthroscopic knee synovectomy, specifically targeting the plica or shelf resection. This code should be used when the procedure is performed as a separate, standalone procedure and not in conjunction with other knee surgeries.

6. Documentation requirements

To support a claim for CPT 29875, the following information should be documented:

  • Patient’s medical history and symptoms related to the knee joint
  • Physical examination findings
  • Diagnostic imaging results (e.g., MRI, X-ray) confirming the presence of inflamed or damaged synovial tissue
  • Conservative treatments attempted and their outcomes
  • Details of the surgical procedure, including the specific synovial tissue targeted and the instruments used
  • Postoperative care instructions and follow-up plan

7. Billing guidelines

When billing for CPT code 29875, it is essential to ensure that the procedure is performed as a separate, standalone surgery and not in conjunction with other knee surgeries. Additionally, the documentation should clearly support the medical necessity of the procedure, including the patient’s history, symptoms, conservative treatments attempted, and diagnostic imaging results. It is also crucial to verify any payer-specific guidelines or requirements related to billing for this code.

8. Historical information

CPT 29875 was added to the Current Procedural Terminology system on January 1, 1990. There have been no significant updates to this code since its addition.

9. Similar codes to CPT 29875

Five similar codes to CPT 29875 and how they differentiate are:

  1. CPT 29870: This code is for diagnostic arthroscopy of the knee, which does not involve any surgical intervention.
  2. CPT 29874: This code is for arthroscopic removal of loose or foreign bodies in the knee joint.
  3. CPT 29876: This code is for a complete synovectomy, involving the removal of the entire synovial membrane in the knee joint.
  4. CPT 29877: This code is for arthroscopic debridement or shaving of articular cartilage in the knee joint.
  5. CPT 29880: This code is for arthroscopic meniscectomy, involving the removal of damaged meniscal tissue in the knee joint.

10. Examples

Here are 10 detailed examples of CPT code 29875 procedures:

  1. A patient with chronic knee pain and swelling due to an inflamed medial plica undergoes a limited arthroscopic synovectomy.
  2. A patient with a history of knee injuries experiences persistent pain and limited mobility, and diagnostic imaging reveals a damaged medial shelf. The patient undergoes a limited arthroscopic synovectomy.
  3. A patient with a painful knee joint, unresponsive to conservative treatments, undergoes a limited arthroscopic synovectomy targeting the inflamed medial plica.
  4. A patient with a history of knee pain and swelling undergoes a limited arthroscopic synovectomy to remove a damaged medial shelf.
  5. A patient with a painful knee joint and limited mobility due to an inflamed medial plica undergoes a limited arthroscopic synovectomy after unsuccessful conservative treatments.
  6. A patient with chronic knee pain and swelling undergoes a limited arthroscopic synovectomy to remove an inflamed medial plica.
  7. A patient with a history of knee injuries and persistent pain undergoes a limited arthroscopic synovectomy to remove a damaged medial shelf.
  8. A patient with a painful knee joint, unresponsive to conservative treatments, undergoes a limited arthroscopic synovectomy targeting the damaged medial shelf.
  9. A patient with a history of knee pain and swelling undergoes a limited arthroscopic synovectomy to remove an inflamed medial plica.
  10. A patient with chronic knee pain and limited mobility due to a damaged medial shelf undergoes a limited arthroscopic synovectomy after unsuccessful conservative treatments.

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