How To Use CPT Code 29888

CPT 29888 is a code for arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction, and this article will cover its description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples.

1. What is CPT 29888?

CPT 29888 is a medical billing code used to describe a specific type of knee surgery, known as arthroscopically aided anterior cruciate ligament (ACL) repair, augmentation, or reconstruction. This code is used by medical coders and billers to accurately document and bill for this procedure when performed by a healthcare provider.

2. 29888 CPT code description

The official description of CPT code 29888 is: “Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction.”

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider makes small incisions in the knee area.
3. An arthroscope is inserted through one of the incisions into the knee joint.
4. Saline solution is instilled to inflate the area around the knee joint and improve the field of view.
5. The provider identifies the tear in the anterior cruciate ligament.
6. Additional instruments are inserted, and the ligament is repaired by harvesting tissue from a tendon in the knee or using a donor graft.
7. The tissue graft is applied, augmenting the anterior cruciate ligament and completing the repair.
8. The area is irrigated, checked for bleeding, and instruments are removed.
9. The incision is closed.

4. Qualifying circumstances

Patients eligible to receive CPT code 29888 services are those who have a torn or damaged anterior cruciate ligament in the knee, causing pain, instability, or limited mobility. This procedure is typically recommended for patients who have not responded to conservative treatments such as physical therapy, bracing, or anti-inflammatory medications. Additionally, patients should be in good overall health and able to tolerate anesthesia and surgery.

5. When to use CPT code 29888

It is appropriate to bill the 29888 CPT code when a healthcare provider performs an arthroscopically aided anterior cruciate ligament repair, augmentation, or reconstruction on a patient who meets the qualifying circumstances mentioned above. The procedure should be medically necessary and supported by appropriate documentation.

6. Documentation requirements

To support a claim for CPT 29888, the following information should be documented in the patient’s medical record:

• Patient’s medical history and physical examination findings
• Diagnostic imaging results (e.g., MRI) confirming the ACL injury
• Conservative treatments attempted and their outcomes
• Indications for surgery and the specific procedure performed
• Operative report detailing the surgical technique, graft choice, and any complications encountered
• Postoperative care plan and follow-up instructions

7. Billing guidelines

When billing for CPT code 29888, it is essential to follow the specific guidelines and rules set forth by the payer. Some payers may not allow separate billing for a surgical assistant during this procedure, so it is crucial to verify medical necessity and payer requirements before submitting a claim. If the payer accepts the assistant provider’s charge, append modifier 80 (Assistant surgeon) or, for some providers, AS (Physician assistant, nurse practitioner, or clinical nurse specialist services, for assistant at surgery).

8. Historical information

CPT 29888 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 29888

Five similar codes to CPT 29888 and how they differentiate are:

• CPT 29880: This code is for a combined medial and lateral meniscectomy, which involves the removal of damaged meniscal tissue in the knee joint.
• CPT 29881: This code is for a partial meniscectomy, which involves the removal of a portion of the damaged meniscal tissue in the knee joint.
• CPT 29882: This code is for a meniscal repair with an all-inside technique, which involves repairing the torn meniscus using an arthroscopic approach without the need for additional incisions.
• CPT 29883: This code is for a meniscal repair with an inside-out or outside-in technique, which involves repairing the torn meniscus using an arthroscopic approach and additional incisions to access the meniscus from different angles.
• CPT 29884: This code is for a meniscal transplant, which involves replacing a damaged meniscus with a donor graft.

10. Examples

1. A 25-year-old athlete with a confirmed ACL tear who has failed conservative treatment and requires surgical intervention.
2. A 40-year-old patient with a chronic ACL injury causing knee instability and affecting daily activities, who has not responded to non-surgical treatments.
3. A 30-year-old patient with a complex ACL tear requiring reconstruction using a donor graft.
4. A 35-year-old patient with a partial ACL tear requiring augmentation to restore knee stability.
5. A 45-year-old patient with a re-tear of a previously reconstructed ACL, necessitating a revision surgery.
6. A 20-year-old patient with a traumatic ACL injury requiring immediate surgical repair to prevent further damage to the knee joint.
7. A 50-year-old patient with a degenerative ACL tear causing significant pain and functional limitations, who has exhausted conservative treatment options.
8. A 28-year-old patient with a combined ACL and meniscal injury requiring both ligament reconstruction and meniscal repair.
9. A 32-year-old patient with a history of multiple ACL injuries requiring a complex reconstruction using a double-bundle technique.
10. A 22-year-old patient with a partial ACL tear and associated cartilage damage requiring both ligament augmentation and cartilage repair.