How To Use CPT Code 29876

CPT 29876 refers to a major knee arthroscopy procedure involving synovectomy in two or more compartments. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 29876.

1. What is CPT 29876?

CPT 29876 is a medical billing code used to describe a specific type of knee arthroscopy procedure, which involves the surgical removal of inflamed or damaged synovial tissue from two or more compartments of the knee joint. This procedure is typically performed to alleviate pain and improve the range of motion in patients suffering from knee joint issues.

2. 29876 CPT code description

The official description of CPT code 29876 is: “Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments (eg, medial or lateral)”.

3. Procedure

The CPT 29876 procedure involves the following steps:

1. The patient is prepped and anesthetized.
2. Small incisions are made in the knee area.
3. An 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, and a major synovectomy is performed, excising the inflamed or damaged synovial membrane from two or more compartments, e.g. medial or lateral.
7. The area is irrigated, and bleeding is checked.
8. Any instruments are removed, and the incisions are closed.

4. Qualifying circumstances

Patients eligible to receive CPT code 29876 services are those who have been diagnosed with knee joint issues that involve inflamed or damaged synovial tissue in two or more compartments of the knee. These issues may be caused by conditions such as arthritis, synovitis, or other joint disorders. The patient should have symptoms such as pain, swelling, and limited range of motion that have not responded to conservative treatments like medication, physical therapy, or injections.

5. When to use CPT code 29876

It is appropriate to bill the 29876 CPT code when a provider performs a major knee arthroscopy procedure involving synovectomy in two or more compartments of the knee joint. This code should be used when the patient has been diagnosed with a condition that requires the removal of inflamed or damaged synovial tissue from multiple compartments of the knee joint to alleviate pain and improve the range of motion.

6. Documentation requirements

To support a claim for CPT 29876, the following information should be documented:

• Patient’s medical history and physical examination findings
• Diagnosis of the knee joint issue requiring synovectomy
• Conservative treatments attempted and their outcomes
• Details of the surgical procedure, including the compartments involved and the extent of synovectomy performed
• Postoperative care instructions and follow-up plan

7. Billing guidelines

When billing for CPT code 29876, it is essential to follow the specific guidelines and rules set by the payer. Some payers may require additional information or have specific reporting guidelines for multiple procedures performed within a single compartment, such as a synovectomy and a meniscectomy. It is crucial to verify the payer’s requirements and ensure that the claim is submitted with accurate and complete information to avoid denials or delays in payment.

8. Historical information

CPT 29876 was added to the Current Procedural Terminology system on January 1, 1990. The code was changed on January 1, 2010, with the previous descriptor being “Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (eg, medial or lateral)”.

9. Similar codes to CPT 29876

Five similar codes to CPT 29876 and how they differentiate are:

• CPT 29870: This code is for diagnostic knee arthroscopy, which does not involve any surgical intervention.
• CPT 29871: This code is for knee arthroscopy with limited synovectomy, involving only one compartment.
• CPT 29873: This code is for knee arthroscopy with meniscectomy or repair, which focuses on the removal or repair of the meniscus rather than synovial tissue.
• CPT 29874: This code is for knee arthroscopy with removal of loose or foreign bodies, which does not involve synovectomy.
• CPT 29875: This code is for knee arthroscopy with debridement or shaving of articular cartilage, which does not involve synovectomy.

10. Examples

Here are 10 detailed examples of CPT code 29876 procedures:

1. A patient with rheumatoid arthritis undergoes a major synovectomy in both the medial and lateral compartments of the knee to alleviate pain and improve mobility.
2. A patient with chronic synovitis in the medial and patellofemoral compartments undergoes a major synovectomy to reduce inflammation and restore joint function.
3. A patient with a history of knee trauma has developed extensive synovial hypertrophy in the medial and lateral compartments, requiring a major synovectomy to relieve pain and improve range of motion.
4. A patient with degenerative joint disease undergoes a major synovectomy in the medial and lateral compartments of the knee to remove inflamed synovial tissue and alleviate joint pain.
5. A patient with a history of multiple knee surgeries has developed recurrent synovitis in the medial and patellofemoral compartments, requiring a major synovectomy to address the ongoing inflammation and pain.
6. A patient with chronic knee pain and limited range of motion undergoes a major synovectomy in the medial and lateral compartments to remove inflamed synovial tissue and improve joint function.
7. A patient with a history of knee infection has developed extensive synovial scarring in the medial and lateral compartments, requiring a major synovectomy to restore joint mobility and alleviate pain.
8. A patient with a history of knee dislocation has developed chronic synovitis in the medial and lateral compartments, requiring a major synovectomy to address the ongoing inflammation and pain.
9. A patient with a history of knee instability has developed extensive synovial hypertrophy in the medial and patellofemoral compartments, requiring a major synovectomy to relieve pain and improve range of motion.
10. A patient with a history of knee surgery has developed recurrent synovitis in the medial and lateral compartments, requiring a major synovectomy to address the ongoing inflammation and pain.