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cherylbr

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Can I please an understanding on billing cpt code 29876 with menisectomy cpt code 29881?

My question is what documentation would support pathological synovitis to support the billing of code 29876?

Must a synovial biopsy need to be done for during the synovectomy to support billing this code or is diagnosis of synovitis enough?

Thank you,
Cheryl
 
Pathologic synovitis would be that associated with rheumatoid arthritis/severe inflammatory arthritis or PVNS (pigmented villonodular synovitis).
This code is really not meant to be used in a limited way for routine knee arthroscopies.
Shaving a bit of synovitis in the knee takes 2 minutes. 29876 is valued at 79 minutes of intraservice time.
General debridement of synovium for visualization, per GSD, is included in 29881, just as synovectomy is included in all shoulder scope codes.
Using this code should be an exception, not typical, and should be extensively documented.
Biopsy, however, is incidental and, if you know the pathology, it is not necessary, and not necessary to bill the code.
 
Pathologic synovitis would be that associated with rheumatoid arthritis/severe inflammatory arthritis or PVNS (pigmented villonodular synovitis).
This code is really not meant to be used in a limited way for routine knee arthroscopies.
Shaving a bit of synovitis in the knee takes 2 minutes. 29876 is valued at 79 minutes of intraservice time.
General debridement of synovium for visualization, per GSD, is included in 29881, just as synovectomy is included in all shoulder scope codes.
Using this code should be an exception, not typical, and should be extensively documented.
Biopsy, however, is incidental and, if you know the pathology, it is not necessary, and not necessary to bill the code.
 
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