How To Use CPT Code 29895

CPT 29895 describes a specific procedure used in arthroscopy of the ankle joint. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 29895?

CPT 29895 is a code used to describe a surgical procedure called synovectomy, partial, performed during arthroscopy of the ankle joint. This procedure involves the examination and repair of the membrane between the bony surfaces and the joint capsule of the tibiotalar and fibulotalar joints in the ankle.

2. Official Description

The official description of CPT code 29895 is: ‘Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; synovectomy, partial.’

3. Procedure

1. The provider begins by making small incisions in the ankle area.
2. An arthroscope, a tubular instrument with a fiberoptic light source and camera, is inserted through one of the incisions to view the tibiotalar and fibulotalar joints.
3. Saline solution is instilled to expand the area around the joints for better visualization.
4. Additional instruments are inserted through the incisions to excise the inflamed portion of the synovial membrane, which is causing pain and limited motion for the patient.
5. The provider irrigates the area, checks for bleeding, removes any instruments, and closes the incisions.

4. Qualifying circumstances

CPT 29895 is performed when a patient experiences pain and limited motion in the ankle joint due to inflammation of the synovial membrane. This procedure is appropriate for patients who have not responded to conservative treatments and require surgical intervention. The provider must use an arthroscope to visualize and perform the synovectomy, partial, in the tibiotalar and fibulotalar joints of the ankle.

5. When to use CPT code 29895

CPT code 29895 should be used when a provider performs a surgical synovectomy, partial, during arthroscopy of the ankle joint. This code is appropriate when the procedure is performed on the tibiotalar and fibulotalar joints and involves the excision of the inflamed portion of the synovial membrane. It is important to note that CPT code 29895 should not be reported with a diagnostic code for the same procedure.

6. Documentation requirements

To support a claim for CPT 29895, the provider must document the following information:

• Patient’s diagnosis and the need for surgical intervention
• Details of the arthroscopic procedure, including the specific joints involved
• Incision sites and the use of an arthroscope
• Procedure start and end time
• Specific steps taken during the synovectomy, partial
• Any complications or additional procedures performed
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 29895, ensure that the procedure meets the criteria for a synovectomy, partial, performed during arthroscopy of the ankle joint. It is important to note that a diagnostic code should not be reported with CPT code 29895. If a diagnostic arthroscopy reveals the need for an open repair of a previously unknown condition, both the open repair and the diagnostic arthroscopy can be reported with the 59 modifier appended to the diagnostic arthroscopy code.

8. Historical information

CPT code 29895 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 with chronic ankle pain undergoes arthroscopy, and the provider performs a synovectomy, partial, in the tibiotalar and fibulotalar joints.
2. An athlete with limited ankle mobility undergoes arthroscopy, and the provider performs a synovectomy, partial, to alleviate the inflammation in the ankle joint.
3. A patient with rheumatoid arthritis experiences severe ankle pain and undergoes arthroscopy, and the provider performs a synovectomy, partial, to improve the patient’s symptoms.
4. A patient with a history of ankle injury and persistent swelling undergoes arthroscopy, and the provider performs a synovectomy, partial, to address the underlying inflammation.
5. An individual with ankle joint degeneration undergoes arthroscopy, and the provider performs a synovectomy, partial, to relieve pain and improve joint function.