How To Use CPT Code 29840

CPT 29840 describes the diagnostic arthroscopy of the wrist joint, which may include a synovial biopsy if necessary. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 29840?

CPT 29840 can be used to describe the diagnostic arthroscopy of the wrist joint. This procedure involves the use of an arthroscope, a small instrument with a camera, to examine the tissue inside the wrist joint. The provider may also perform a synovial biopsy, which involves taking a sample of the synovial tissue for further analysis and diagnosis.

2. Official Description

The official description of CPT code 29840 is: ‘Arthroscopy, wrist, diagnostic, with or without synovial biopsy (separate procedure).’ This code specifically refers to the diagnostic arthroscopy of the wrist joint, which may include a synovial biopsy if necessary.

3. Procedure

1. The provider begins by preparing and anesthetizing the patient.
2. A small incision is made in the wrist area to allow the insertion of the arthroscope.
3. The provider inserts the arthroscope into the wrist joint and instills saline solution to expand the area for better visibility.
4. Using the camera of the arthroscope, the provider carefully examines the entire joint area, including the ligaments and other structures in the wrist.
5. If necessary, the provider may take a biopsy of the synovial tissue for further analysis and diagnosis.
6. After completing the examination and any necessary procedures, the provider irrigates the area, checks for bleeding, removes the instruments, and closes the incision.

4. Qualifying circumstances

CPT 29840 is typically performed when a patient presents with wrist pain and limited movement, and the provider needs to assess the cause of these symptoms. The procedure is appropriate for patients who require a diagnostic evaluation of the wrist joint. The provider must determine the need for a synovial biopsy based on the patient’s condition and symptoms.

5. When to use CPT code 29840

CPT code 29840 should be used when a provider performs a diagnostic arthroscopy of the wrist joint. This code is appropriate when the primary purpose of the procedure is to evaluate the wrist joint and potentially perform a synovial biopsy. It should not be used for surgical repair procedures or when the arthroscopy is performed for a different joint.

6. Documentation requirements

To support a claim for CPT 29840, the provider must document the following information:

• Reason for the diagnostic arthroscopy and the need for a synovial biopsy, if performed
• Details of the procedure, including the incision, insertion of the arthroscope, and examination of the wrist joint
• Any additional procedures performed, such as a synovial biopsy
• Findings from the arthroscopy and biopsy, if applicable
• Any complications or adverse events that occurred during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 29840, ensure that the procedure performed is a diagnostic arthroscopy of the wrist joint. This code should not be reported with a surgical code or a separate procedure code for the synovial biopsy. If both a diagnostic arthroscopy and an open repair are performed, append the 59 modifier to the diagnostic arthroscopy code to indicate that it is a distinct procedural service.

8. Historical information

CPT 29840 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 presents with persistent wrist pain and limited movement. The provider performs a diagnostic arthroscopy of the wrist joint to assess the cause of the symptoms. No synovial biopsy is necessary.
2. A patient with a history of wrist injury experiences recurring pain. The provider performs a diagnostic arthroscopy of the wrist joint and also takes a synovial biopsy to further investigate the cause of the symptoms.
3. A patient with rheumatoid arthritis complains of worsening wrist pain. The provider performs a diagnostic arthroscopy of the wrist joint and identifies inflammation in the synovial tissue during the examination.
4. A patient with a suspected ligament tear in the wrist undergoes a diagnostic arthroscopy. The provider confirms the tear and proceeds with a surgical repair during the same procedure.
5. A patient with chronic wrist pain undergoes a diagnostic arthroscopy, which reveals no significant abnormalities. The provider recommends conservative treatment options based on the findings.
6. A patient with a history of wrist trauma presents with persistent swelling and discomfort. The provider performs a diagnostic arthroscopy and discovers a loose body in the wrist joint, which is removed during the procedure.
7. A patient with a suspected infection in the wrist joint undergoes a diagnostic arthroscopy. The provider takes a synovial biopsy to confirm the presence of an infection and determines the appropriate course of treatment.
8. A patient with a history of wrist arthritis experiences worsening pain and stiffness. The provider performs a diagnostic arthroscopy and identifies significant cartilage damage, which requires debridement during the same procedure.
9. A patient with chronic wrist instability undergoes a diagnostic arthroscopy. The provider discovers a tear in the triangular fibrocartilage complex (TFCC) and proceeds with a surgical repair during the same procedure.