How To Use CPT Code 29877

CPT 29877 refers to the arthroscopic debridement or shaving of articular cartilage in the knee joint. This article will cover the code description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples.

1. What is CPT 29877?

CPT 29877 is a medical procedure code used to describe the arthroscopic debridement or shaving of articular cartilage in the knee joint. This procedure is performed to relieve pain and improve mobility in the joint by reshaping the cartilage lining of the joint surfaces.

2. 29877 CPT code description

The official description of CPT code 29877 is: “Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)”.

3. Procedure

The 29877 procedure involves the following steps:

1. The patient is appropriately prepped and anesthetized.
2. The provider makes small incisions in the knee area.
3. The arthroscope is inserted through one of the incisions into the knee joint.
4. Saline solution is instilled into the area to expand the area around the knee joint.
5. The provider inspects the joint and uses instruments to reshape the cartilage lining of the joint surfaces by debriding and or shaving the surfaces.
6. The area is irrigated, and the provider checks for bleeding.
7. Any instruments are removed, and the incisions are closed.

4. Qualifying circumstances

Patients eligible to receive CPT code 29877 services are those experiencing pain, limited mobility, or other symptoms related to damaged articular cartilage in the knee joint. This procedure is typically recommended for patients who have not responded to conservative treatments such as physical therapy, medication, or injections. The provider will evaluate the patient’s medical history, symptoms, and imaging studies to determine if the procedure is appropriate.

5. When to use CPT code 29877

It is appropriate to bill the 29877 CPT code when the provider performs an arthroscopic debridement or shaving of articular cartilage in the knee joint to relieve pain and improve mobility. This code should be used only when the procedure is performed as a standalone service or in conjunction with other arthroscopic procedures that do not include debridement or shaving of articular cartilage.

6. Documentation requirements

To support a claim for CPT 29877, the following information should be documented:

• Patient’s medical history, including symptoms and previous treatments
• Physical examination findings
• Imaging studies, such as X-rays or MRIs, showing the damaged articular cartilage
• Indication for the procedure and its necessity
• Details of the procedure, including the steps performed, instruments used, and any complications encountered
• Postoperative care instructions and follow-up plan

7. Billing guidelines

When billing for CPT code 29877, it is essential to follow the appropriate guidelines and rules. Some tips and codes that apply to this procedure include:

• Do not use a diagnostic code with a surgical code, as surgical endoscopy and arthroscopy always include a diagnostic endoscopy or arthroscopy code.
• If the provider performs a diagnostic arthroscopy and discovers the need for an open repair of a previously unknown condition, report both the open repair and the diagnostic arthroscopy by appending the 59 modifier, Distinct procedural service, to the diagnostic arthroscopy code.
• When performed with arthroscopic meniscectomy, see CPT codes 29880 or 29881.

8. Historical information

CPT 29877 was added to the Current Procedural Terminology system on January 1, 1990. There have been no significant updates to the code since its addition.

9. Similar codes to CPT 29877

Five similar codes to CPT 29877 and how they differentiate from it are:

1. CPT 29874: Involves the removal of loose or foreign bodies from the knee joint.
2. CPT 29875: Focuses on the synovectomy, or removal of the inflamed synovial tissue, in the knee joint.
3. CPT 29876: Addresses the removal of both loose or foreign bodies and synovial tissue from the knee joint.
4. CPT 29880: Combines the arthroscopic meniscectomy with the debridement or shaving of articular cartilage.
5. CPT 29881: Involves the arthroscopic meniscectomy without the debridement or shaving of articular cartilage.

10. Examples

Here are 10 detailed examples of CPT code 29877 procedures:

1. A patient with chronic knee pain and limited mobility undergoes arthroscopic debridement of articular cartilage to improve joint function.
2. A patient with osteoarthritis has arthroscopic shaving of articular cartilage to alleviate pain and inflammation in the knee joint.
3. A patient with a history of knee injuries undergoes arthroscopic chondroplasty to address damaged cartilage and restore joint mobility.
4. A patient with persistent knee pain despite conservative treatments has arthroscopic debridement of articular cartilage to improve joint function and reduce pain.
5. A patient with a meniscal tear undergoes arthroscopic meniscectomy and chondroplasty (CPT 29880) to address both the torn meniscus and damaged articular cartilage.
6. A patient with a history of knee instability undergoes arthroscopic debridement of articular cartilage to improve joint stability and function.
7. A patient with degenerative joint disease has arthroscopic shaving of articular cartilage to alleviate pain and improve joint mobility.
8. A patient with a history of knee dislocations undergoes arthroscopic chondroplasty to address damaged cartilage and restore joint function.
9. A patient with chronic knee pain and swelling has arthroscopic debridement of articular cartilage to reduce inflammation and improve joint function.
10. A patient with a history of knee surgeries undergoes arthroscopic shaving of articular cartilage to address residual cartilage damage and restore joint mobility.