How To Use CPT Code 29892

CPT 29892 describes the arthroscopically aided repair of large osteochondritis dissecans lesion, talar dome fracture, or tibial plafond fracture, with or without internal 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 29892?

CPT 29892 is used to describe a surgical procedure that involves the arthroscopically aided repair of large osteochondritis dissecans lesion, talar dome fracture, or tibial plafond fracture. This procedure may or may not include internal fixation, such as the insertion of screws to secure cartilage to bone. It is typically performed to address defects in the cartilage and bone within the ankle joint.

2. Official Description

The official description of CPT code 29892 is: ‘Arthroscopically aided repair of large osteochondritis dissecans lesion, talar dome fracture, or tibial plafond fracture, with or without internal fixation (includes arthroscopy).’ This code encompasses the use of an arthroscope to examine the tissue inside the ankle joint, identify areas of concern, and perform repairs as necessary.

3. Procedure

1. The provider begins by making small incisions in the ankle area and inserts an arthroscope, a tubular instrument with a fiberoptic light source and camera, into the joint.
2. Saline solution is instilled to inflate the area around the ankle joint, improving visibility.
3. The provider identifies the areas of concern, such as osteochondritis dissecans lesions, talar dome fractures, or tibial plafond fractures.
4. She then proceeds to repair these defects, which may involve techniques such as bone grafting or the insertion of screws for internal fixation.
5. After completing the repairs, the provider irrigates the area, checks for bleeding, removes any instruments, and closes the incisions.

4. Qualifying circumstances

CPT 29892 is typically performed on patients with large osteochondritis dissecans lesions, talar dome fractures, or tibial plafond fractures. These conditions may cause significant pain, limited mobility, and other symptoms that warrant surgical intervention. The procedure is performed by a qualified healthcare professional who is trained in arthroscopic techniques and has the necessary expertise to address these specific conditions.

5. When to use CPT code 29892

CPT code 29892 should be used when the provider performs an arthroscopically aided repair of a large osteochondritis dissecans lesion, talar dome fracture, or tibial plafond fracture. It is important to accurately document the specific condition being addressed and the extent of the repair performed, including whether internal fixation was utilized. This code should not be used for other types of ankle surgeries or repairs.

6. Documentation requirements

To support a claim for CPT 29892, the provider must document the following information:

• The specific condition being addressed (osteochondritis dissecans lesion, talar dome fracture, or tibial plafond fracture)
• The use of arthroscopy and any additional techniques employed during the procedure
• The extent of the repair performed, including whether internal fixation was utilized
• Any additional procedures or interventions performed during the same surgical session
• Any complications or unexpected findings encountered during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 29892, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The use of an arthroscope and the repair of large osteochondritis dissecans lesions, talar dome fractures, or tibial plafond fractures should be clearly documented. It is also important to follow any additional guidelines or requirements set forth by the payer or coding guidelines.

8. Historical information

CPT 29892 was added to the Current Procedural Terminology system on January 1, 1998. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoes arthroscopically aided repair of a large osteochondritis dissecans lesion in the ankle joint.
2. A provider performs arthroscopically aided repair of a talar dome fracture using internal fixation.
3. An individual undergoes arthroscopically aided repair of a tibial plafond fracture without internal fixation.
4. A patient requires arthroscopically aided repair of both a talar dome fracture and a tibial plafond fracture, with internal fixation.
5. A provider performs arthroscopically aided repair of a large osteochondritis dissecans lesion, talar dome fracture, and tibial plafond fracture, with internal fixation.