How To Use CPT Code 29891

CPT 29891 describes the surgical procedure of arthroscopy on the ankle joint to excise an osteochondral defect of the talus and/or tibia, including drilling of the defect. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 29891?

CPT 29891 is used to describe a surgical procedure known as arthroscopy, which involves the examination and treatment of the ankle joint. Specifically, this code is used when the provider identifies and repairs an osteochondral defect in the cartilage covering the talus (ankle bone) and/or the tibia (lower leg bone). The procedure includes the excision of the defect and the drilling of holes in the underlying bone to promote the growth of healthy tissue. By performing this procedure, the provider aims to alleviate pain and improve mobility in the ankle joint.

2. Official Description

The official description of CPT code 29891 is: ‘Arthroscopy, ankle, surgical, excision of osteochondral defect of talus and/or tibia, including drilling of the defect.’

3. Procedure

1. The provider begins by preparing the patient and administering anesthesia.
2. Small incisions are made in the ankle area to allow for the insertion of an arthroscope, a specialized instrument with a light source and camera for visualizing the joint.
3. A saline solution is introduced to the joint to improve visibility.
4. The provider identifies the osteochondral defect, which refers to an area of damaged cartilage and bone.
5. Using additional instruments, the provider excises the defect and drills holes in the underlying bone to stimulate the growth of healthy tissue.
6. The joint is irrigated, any bleeding is addressed, and the incisions are closed.

4. Qualifying circumstances

CPT 29891 is performed on patients who have been diagnosed with an osteochondral defect in the ankle joint. This condition involves damage to the cartilage and bone surfaces of the talus and/or tibia. The procedure is typically carried out by a provider who specializes in arthroscopy and has the necessary expertise to perform the excision and drilling. It is important to note that this code is specific to the ankle joint and should not be used for similar procedures on other joints.

5. When to use CPT code 29891

CPT code 29891 should be used when a provider performs arthroscopy on the ankle joint to excise an osteochondral defect of the talus and/or tibia, including drilling of the defect. It is important to ensure that the procedure meets the specific criteria outlined in the code description. If the procedure involves additional repairs or treatments beyond the excision and drilling, separate codes may be required to accurately represent the services provided.

6. Documentation requirements

Documentation for CPT code 29891 should include the following:

• Confirmation of the patient’s diagnosis of an osteochondral defect in the ankle joint
• Description of the specific areas of the talus and/or tibia affected by the defect
• Details of the procedure performed, including the excision of the defect and the drilling of holes in the bone
• Any additional repairs or treatments performed during the same surgical session
• Confirmation of the use of an arthroscope and other specialized instruments
• Documentation of the patient’s response to the procedure and any post-operative instructions provided

7. Billing guidelines

When billing for CPT code 29891, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The provider should be qualified and experienced in performing arthroscopy on the ankle joint. It is also important to follow any additional guidelines provided by the payer or relevant coding authorities. It is generally not appropriate to report CPT code 29891 with a diagnostic arthroscopy code, as the surgical procedure includes a diagnostic component. However, if a diagnostic arthroscopy leads to the discovery of an additional condition requiring open repair, both the diagnostic arthroscopy and the open repair can be reported with the appropriate modifiers.

8. Historical information

CPT code 29891 was added to the Current Procedural Terminology system on January 1, 1998. Since its addition, there have been no updates or changes to the code.

9. Examples

1. A patient undergoes arthroscopy on their ankle joint to excise an osteochondral defect of the talus, including drilling of the defect.
2. A provider performs arthroscopy on a patient’s ankle joint to excise an osteochondral defect of the tibia, including drilling of the defect.
3. During the procedure, the provider identifies and repairs an osteochondral defect in both the talus and tibia of the patient’s ankle joint.
4. A patient with a known osteochondral defect in their ankle joint undergoes arthroscopy for excision and drilling.
5. A provider performs arthroscopy on a patient’s ankle joint to excise an osteochondral defect of the talus, including drilling of the defect, as well as additional repairs to address other joint issues.
6. During the procedure, the provider discovers multiple osteochondral defects in the patient’s ankle joint and performs excision and drilling for each defect.
7. A patient with persistent ankle pain undergoes arthroscopy, which reveals an osteochondral defect that is subsequently excised and drilled.
8. A provider performs arthroscopy on a patient’s ankle joint to excise an osteochondral defect of the tibia, including drilling of the defect, and also performs a synovectomy during the same procedure.