How To Use CPT Code 29886

CPT 29886 describes a specific arthroscopic procedure performed on the knee joint to address intact osteochondritis dissecans lesions. This article will provide an overview of the code, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of when CPT 29886 may be used.

1. What is CPT Code 29886?

CPT 29886 is a code used to describe a surgical procedure known as drilling for intact osteochondritis dissecans lesions in the knee joint. This procedure involves the use of an arthroscope, a specialized instrument with a fiberoptic light source and camera, to examine the tissue inside the knee joint and identify intact osteochondritis dissecans lesions. These are lesions where the cartilage is cracked but has not yet separated from the bone. The purpose of the procedure is to drill the damaged cartilage, promoting the growth of healthy tissue and improving pain and mobility in the joint.

2. Official Description

The official description of CPT code 29886 is: ‘Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion.’

3. Procedure

1. After appropriate patient preparation and anesthesia, the healthcare provider makes small incisions in the knee area.
2. An arthroscope is inserted through one of the incisions into the knee joint.
3. A saline solution is instilled to inflate the area around the knee joint, improving visibility.
4. The provider identifies an intact osteochondritis dissecans lesion.
5. A drill is inserted, and multiple holes are drilled in the damaged cartilage to encourage new tissue growth.
6. The area is irrigated, checked for bleeding, and any instruments are removed.
7. The incision is closed.

4. Qualifying circumstances

CPT 29886 is used when a patient has intact osteochondritis dissecans lesions in the knee joint. These lesions occur when the cartilage layer separates from the end of the bone following an injury. The procedure is performed by a healthcare provider who is trained in arthroscopic techniques and has the necessary equipment to perform the drilling. It is important to note that CPT 29886 should not be reported with a diagnostic code, as it is a surgical procedure.

5. When to use CPT code 29886

CPT code 29886 should be used when a healthcare provider performs the drilling procedure for intact osteochondritis dissecans lesions in the knee joint. It is important to ensure that the patient meets the qualifying circumstances and that the procedure is performed using arthroscopic techniques. This code should not be used for diagnostic purposes or in conjunction with a diagnostic code.

6. Documentation requirements

To support a claim for CPT 29886, the healthcare provider must document the following information:

• Patient’s diagnosis of intact osteochondritis dissecans lesions in the knee joint
• Description of the procedure performed, including the use of arthroscopic techniques
• Date of the procedure
• Details of the drilling procedure, including the number of holes drilled
• Confirmation of irrigation, absence of bleeding, and removal of instruments
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 29886, it is important to ensure that the procedure meets the criteria outlined in the official description. The procedure should be performed using arthroscopic techniques, and the documentation should support the drilling of intact osteochondritis dissecans lesions in the knee joint. It is also important to avoid reporting CPT 29886 with a diagnostic code, as it is a surgical procedure. Additionally, modifiers such as RT (Right side) or LT (Left side) should be used to indicate the specific anatomical site.

8. Historical information

CPT 29886 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 intact osteochondritis dissecans lesions in their right knee joint. The healthcare provider performs the drilling procedure using arthroscopic techniques to encourage new tissue growth.
2. During an arthroscopic examination of a patient’s knee joint, intact osteochondritis dissecans lesions are identified. The healthcare provider proceeds to drill multiple holes in the damaged cartilage to promote healing and improve joint function.
3. A professional athlete sustains an injury to their knee, resulting in intact osteochondritis dissecans lesions. The healthcare provider performs the drilling procedure to address the lesions and facilitate the athlete’s return to sports.
4. A patient with intact osteochondritis dissecans lesions in their left knee joint undergoes the drilling procedure to promote the growth of healthy tissue and alleviate pain and mobility issues.
5. Following a thorough evaluation, a healthcare provider determines that a patient’s intact osteochondritis dissecans lesions in their knee joint require the drilling procedure. The procedure is performed using arthroscopic techniques to achieve optimal results.
6. A young patient is diagnosed with intact osteochondritis dissecans lesions in their knee joint. The healthcare provider recommends and performs the drilling procedure to address the lesions and prevent further complications.
7. After experiencing persistent knee pain, a patient undergoes an arthroscopic examination that reveals intact osteochondritis dissecans lesions. The healthcare provider proceeds with the drilling procedure to promote healing and improve the patient’s quality of life.