How To Use CPT Code 29821

CPT 29821 describes a specific arthroscopy procedure performed on the shoulder joint. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 29821?

CPT 29821 is a code used to describe a surgical procedure called arthroscopy, specifically performed on the shoulder joint. This procedure involves the examination and removal of damaged synovial membrane between the bony surfaces and the joint capsule. It is typically performed to address chronic inflammatory conditions that cause pain, limited motion, or to remove a tumor.

2. Official Description

The official description of CPT code 29821 is: ‘Arthroscopy, shoulder, surgical; synovectomy, complete.’ This code specifically refers to the complete removal of the synovial tissue in the shoulder joint using an arthroscope.

3. Procedure

1. The surgeon begins by making three small incisions in the shoulder area.
2. An arthroscope, a tubular instrument with a fiberoptic light source and camera, is inserted through one of the incisions into the shoulder joint.
3. Saline solution is then instilled to expand the area around the shoulder joint, allowing for better visualization.
4. The surgeon uses the camera of the arthroscope to view the entire shoulder joint area.
5. Additional instruments are inserted through the other incisions to excise the entire synovial membrane.
6. After the procedure, the area is irrigated, checked for bleeding, and the incisions are closed.

4. Qualifying circumstances

CPT 29821 is performed when a patient presents with chronic inflammatory conditions in the shoulder joint that cause pain and limited motion, or when there is a need to remove a tumor. The procedure is typically performed by a surgeon who specializes in arthroscopic surgeries.

5. When to use CPT code 29821

CPT code 29821 should be used when a complete synovectomy of the shoulder joint is performed using arthroscopy. It is important to note that this code should not be used for diagnostic arthroscopy procedures or open repairs of previously unknown conditions.

6. Documentation requirements

To support a claim for CPT 29821, the surgeon must document the following information:

• Patient’s diagnosis and the need for a complete synovectomy
• Details of the arthroscopic procedure, including the specific instruments used
• Date of the procedure
• Any complications or unexpected findings during the procedure
• Post-operative care instructions
• Signature of the performing surgeon

7. Billing guidelines

When billing for CPT 29821, ensure that the procedure meets the criteria for a complete synovectomy of the shoulder joint using arthroscopy. It is important to note that a diagnostic arthroscopy should not be reported with a surgical code. If an open repair is performed in addition to a diagnostic arthroscopy, the 59 modifier should be appended to the diagnostic arthroscopy code.

8. Historical information

CPT 29821 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with chronic shoulder pain and limited motion undergoes arthroscopic synovectomy to alleviate their symptoms.
2. A tumor is discovered in the synovial membrane of a patient’s shoulder joint, leading to the performance of arthroscopic synovectomy.
3. A surgeon performs arthroscopic synovectomy on a patient with a chronic inflammatory condition affecting their shoulder joint.
4. A patient with a history of shoulder inflammation undergoes arthroscopic synovectomy to improve their range of motion.
5. Arthroscopic synovectomy is performed on a patient with a suspected tumor in their shoulder joint.
6. A patient with chronic shoulder pain and inflammation undergoes arthroscopic synovectomy to address their condition.
7. A surgeon performs arthroscopic synovectomy on a patient with a chronic inflammatory condition causing significant shoulder discomfort.
8. A patient with limited shoulder mobility due to chronic inflammation undergoes arthroscopic synovectomy to improve their quality of life.
9. Arthroscopic synovectomy is performed on a patient with a tumor in their shoulder joint to remove the abnormal growth.
10. A surgeon performs arthroscopic synovectomy on a patient with chronic shoulder pain and inflammation to provide relief and improve function.