How To Use CPT Code 29846

CPT 29846 describes a surgical procedure involving the excision and/or repair of the triangular fibrocartilage and/or joint debridement in the wrist. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 29846?

CPT 29846 is a code used to describe a surgical procedure performed on the wrist. It involves the excision and/or repair of the triangular fibrocartilage, which is a supporting cartilage in the wrist that can cause pain when damaged. Additionally, limited debridement of the wrist joint may be performed to remove any additional damaged tissue.

2. Official Description

The official description of CPT code 29846 is: ‘Arthroscopy, wrist, surgical; excision and/or repair of triangular fibrocartilage and/or joint debridement.’

3. Procedure

1. The provider begins by making small incisions in the wrist area.
2. An arthroscope, a tubular instrument with a fiberoptic light source and camera, is inserted through one of the incisions into the wrist joint.
3. Saline solution is instilled to expand the area around the wrist joint, improving the provider’s field of view.
4. The provider uses the arthroscope to inspect the entire wrist joint area.
5. Additional instruments are inserted to excise and/or repair the triangular fibrocartilage and perform limited debridement of the wrist joint.
6. The area is irrigated, checked for bleeding, and any instruments are removed.
7. The incision is closed.

4. Qualifying circumstances

CPT 29846 is performed on patients who have damage to the triangular fibrocartilage in the wrist, which causes pain and requires excision and/or repair. The procedure is typically performed by a provider who specializes in arthroscopic surgery and has the necessary training and expertise to perform the procedure safely and effectively.

5. When to use CPT code 29846

CPT code 29846 should be used when a provider performs the excision and/or repair of the triangular fibrocartilage and/or joint debridement in the wrist using arthroscopic techniques. It is important to note that this code should not be used for diagnostic arthroscopy procedures, as it is specifically for surgical interventions.

6. Documentation requirements

To support a claim for CPT 29846, the provider must document the following information:

• Patient’s diagnosis and the need for the surgical procedure
• Details of the procedure performed, including the excision and/or repair of the triangular fibrocartilage and any joint debridement
• Date of the procedure
• Any additional findings or procedures performed during the arthroscopy
• Any complications or adverse events that occurred during or after the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 29846, it is important to ensure that the procedure was performed using arthroscopic techniques and involved the excision and/or repair of the triangular fibrocartilage and/or joint debridement. This code should not be reported with diagnostic arthroscopy codes. If a diagnostic arthroscopy is performed and a surgical intervention is also performed, the 59 modifier should be appended to the diagnostic arthroscopy code to indicate that it was a distinct procedural service.

8. Historical information

CPT 29846 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A patient undergoes arthroscopic surgery for the excision and repair of the triangular fibrocartilage in the wrist.
2. A provider performs arthroscopic joint debridement in the wrist to remove damaged tissue.
3. An individual with wrist pain undergoes arthroscopic surgery, during which the provider excises the triangular fibrocartilage and performs limited debridement.
4. A patient with a wrist injury requires surgical intervention, including the repair of the triangular fibrocartilage using arthroscopic techniques.
5. A provider performs arthroscopic surgery to repair a tear in the triangular fibrocartilage complex (TFCC) in the wrist.
6. An individual with a wrist fracture undergoes arthroscopic surgery for the excision and repair of the triangular fibrocartilage, as well as the treatment of the fracture.
7. A patient with chronic wrist pain undergoes arthroscopic surgery, during which the provider performs extensive debridement of the wrist joint.
8. An individual with wrist instability undergoes arthroscopic surgery, during which the provider performs interposition arthroplasty in the intercarpal or carpometacarpal joints.
9. A provider performs arthroscopic surgery to repair a tear in the triangular fibrocartilage complex (TFCC) and shortens the ulna to treat wrist pain.
10. An individual with a wrist fracture and associated ligament damage undergoes arthroscopic surgery, during which the provider repairs the fracture and performs necessary joint debridement.