How To Use CPT Code 29851

CPT 29851 describes the arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation, using internal or external fixation. 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 29851?

CPT 29851 is used to describe a procedure in which a provider uses an arthroscope to treat a fracture of the upper tibia’s intercondylar spine(s) and/or tuberosity. The procedure may involve manipulation of the fracture and the use of internal or external fixation devices to stabilize the fracture. Arthroscopy, also known as keyhole surgery, allows the provider to examine and treat joint problems using a tiny camera inserted through small incisions.

2. Official Description

The official description of CPT code 29851 is: ‘Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy).’

3. Procedure

1. The provider prepares the patient and administers anesthesia.
2. Two small incisions are made on either side of the patellar tendon over the knee joint.
3. An arthroscope is inserted through one of the incisions to visualize the fracture.
4. The provider debrides any damaged tissue within the joint.
5. If the fracture fragments are displaced, the provider may manipulate them to realign the bones.
6. Internal or external fixation devices, such as screws, are used to stabilize the fracture.
7. All instruments are removed, and the incisions are closed.
8. A drain may be placed, and the incisions are covered with bandages.
9. In some cases, the patient may be placed in a brace for four weeks to aid in the healing process.

4. Qualifying circumstances

CPT 29851 is performed on patients with a fracture of the upper tibia’s intercondylar spine(s) and/or tuberosity. The procedure may involve manipulation of the fracture and the use of internal or external fixation devices. The provider must use an arthroscope to visualize and treat the fracture.

5. When to use CPT code 29851

CPT code 29851 should be used when a provider performs arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation, using internal or external fixation. This code should not be used if the procedure does not involve the use of an arthroscope or if internal or external fixation devices are not used.

6. Documentation requirements

To support a claim for CPT 29851, the provider must document the following information:

• Patient’s diagnosis of a fracture of the intercondylar spine(s) and/or tuberosity
• Details of the procedure, including the use of an arthroscope and any manipulation or fixation devices
• Date of the procedure
• Start and end time of the procedure
• Any additional procedures or treatments performed during the same session
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 29851, ensure that the procedure meets the criteria described in the official description. The use of an arthroscope and internal or external fixation devices is necessary for reporting this code. It is important to follow any additional guidelines provided by payers regarding the documentation and reporting of this procedure.

8. Historical information

CPT 29851 was added to the Current Procedural Terminology system on January 1, 1993. There have been no updates to the code since its addition.

9. Examples

1. A provider performs arthroscopically aided treatment of a fracture of the intercondylar spine of the knee, using internal fixation devices.
2. A patient presents with a tuberosity fracture of the knee, and the provider performs arthroscopically aided treatment with manipulation and external fixation.
3. A provider uses an arthroscope to treat a fracture of the intercondylar spine and tuberosity of the knee, without manipulation, using internal fixation devices.
4. A patient undergoes arthroscopically aided treatment of a tuberosity fracture of the knee, with manipulation and external fixation, using an arthroscope.
5. A provider performs arthroscopically aided treatment of a fracture of the intercondylar spine and tuberosity of the knee, with manipulation and internal fixation, using an arthroscope.
6. An individual undergoes arthroscopically aided treatment of a tuberosity fracture of the knee, without manipulation, using external fixation devices.