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29855 | Tibial arthroscopy/surgery | HCPCS | CPT Codes for Arthroscopy and Arthroplasty Knee Procedures
Knee Arthroscopy CPT codes
29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29866 – Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
29867 – Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875 (Limited synovectomy, “separate procedure”)
29876 – Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879 – Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
29884 – Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29888 – Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 – Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty)
Knee Arthroplasty CPT Codes
27438 Arthroplasty, patella; with prosthesis
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methyl methacrylate with or without insertion of spacer, knee
The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
- CPT codes 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) should not be reported with other knee arthroscopy codes (29866-29889). - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. |
27486 | REVISION TKA | HCPCS | CPT Codes for Arthroscopy and Arthroplasty Knee Procedures
Knee Arthroscopy CPT codes
29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29866 – Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
29867 – Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875 (Limited synovectomy, “separate procedure”)
29876 – Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879 – Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
29884 – Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29888 – Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 – Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty)
Knee Arthroplasty CPT Codes
27438 Arthroplasty, patella; with prosthesis
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methyl methacrylate with or without insertion of spacer, knee
The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
- CPT codes 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) should not be reported with other knee arthroscopy codes (29866-29889). - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. |
29999 | Unlisted px arthroscopy | HCPCS | CPT Codes for Arthroscopy and Arthroplasty Knee Procedures
Knee Arthroscopy CPT codes
29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29866 – Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
29867 – Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875 (Limited synovectomy, “separate procedure”)
29876 – Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879 – Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
29884 – Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29888 – Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 – Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty)
Knee Arthroplasty CPT Codes
27438 Arthroplasty, patella; with prosthesis
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methyl methacrylate with or without insertion of spacer, knee
The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
- CPT codes 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) should not be reported with other knee arthroscopy codes (29866-29889). - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. |
29875 | PR ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX | HCPCS | CPT Codes for Arthroscopy and Arthroplasty Knee Procedures
Knee Arthroscopy CPT codes
29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29866 – Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
29867 – Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875 (Limited synovectomy, “separate procedure”)
29876 – Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879 – Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
29884 – Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29888 – Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 – Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty)
Knee Arthroplasty CPT Codes
27438 Arthroplasty, patella; with prosthesis
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methyl methacrylate with or without insertion of spacer, knee
The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
- CPT codes 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) should not be reported with other knee arthroscopy codes (29866-29889). - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. |
27487 | Revision of thigh and lower leg bone components of total knee joint prosthesis | HCPCS | CPT Codes for Arthroscopy and Arthroplasty Knee Procedures
Knee Arthroscopy CPT codes
29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29866 – Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
29867 – Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875 (Limited synovectomy, “separate procedure”)
29876 – Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879 – Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
29884 – Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29888 – Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 – Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty)
Knee Arthroplasty CPT Codes
27438 Arthroplasty, patella; with prosthesis
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methyl methacrylate with or without insertion of spacer, knee
The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
- CPT codes 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) should not be reported with other knee arthroscopy codes (29866-29889). - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. |
27447 | Total knee arthroplasty | HCPCS | CPT Codes for Arthroscopy and Arthroplasty Knee Procedures
Knee Arthroscopy CPT codes
29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29866 – Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
29867 – Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875 (Limited synovectomy, “separate procedure”)
29876 – Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879 – Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
29884 – Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29888 – Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 – Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty)
Knee Arthroplasty CPT Codes
27438 Arthroplasty, patella; with prosthesis
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methyl methacrylate with or without insertion of spacer, knee
The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
- CPT codes 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) should not be reported with other knee arthroscopy codes (29866-29889). - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. |
29870 | PR ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX | HCPCS | CPT Codes for Arthroscopy and Arthroplasty Knee Procedures
Knee Arthroscopy CPT codes
29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29866 – Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
29867 – Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875 (Limited synovectomy, “separate procedure”)
29876 – Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879 – Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
29884 – Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29888 – Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 – Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty)
Knee Arthroplasty CPT Codes
27438 Arthroplasty, patella; with prosthesis
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methyl methacrylate with or without insertion of spacer, knee
The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
- CPT codes 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) should not be reported with other knee arthroscopy codes (29866-29889). - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. |
29866 | PR ARTHROSCOPY KNEE OSTEOCHONDRAL AGRFT MOSAICPLAST | HCPCS | CPT Codes for Arthroscopy and Arthroplasty Knee Procedures
Knee Arthroscopy CPT codes
29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29866 – Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
29867 – Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875 (Limited synovectomy, “separate procedure”)
29876 – Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879 – Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
29884 – Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29888 – Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 – Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty)
Knee Arthroplasty CPT Codes
27438 Arthroplasty, patella; with prosthesis
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methyl methacrylate with or without insertion of spacer, knee
The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
- CPT codes 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) should not be reported with other knee arthroscopy codes (29866-29889). - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. |
29889 | PR ARTHRS AIDED PST CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ | HCPCS | CPT Codes for Arthroscopy and Arthroplasty Knee Procedures
Knee Arthroscopy CPT codes
29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29866 – Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
29867 – Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875 (Limited synovectomy, “separate procedure”)
29876 – Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879 – Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
29884 – Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29888 – Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 – Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty)
Knee Arthroplasty CPT Codes
27438 Arthroplasty, patella; with prosthesis
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methyl methacrylate with or without insertion of spacer, knee
The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
- CPT codes 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) should not be reported with other knee arthroscopy codes (29866-29889). - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. |
27438 | Revise kneecap with implant | HCPCS | CPT Codes for Arthroscopy and Arthroplasty Knee Procedures
Knee Arthroscopy CPT codes
29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29866 – Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
29867 – Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875 (Limited synovectomy, “separate procedure”)
29876 – Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879 – Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
29884 – Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29888 – Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 – Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty)
Knee Arthroplasty CPT Codes
27438 Arthroplasty, patella; with prosthesis
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methyl methacrylate with or without insertion of spacer, knee
The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
- CPT codes 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) should not be reported with other knee arthroscopy codes (29866-29889). - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. |
29876 | PR ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS | HCPCS | CPT Codes for Arthroscopy and Arthroplasty Knee Procedures
Knee Arthroscopy CPT codes
29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29866 – Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
29867 – Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875 (Limited synovectomy, “separate procedure”)
29876 – Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879 – Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
29884 – Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29888 – Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 – Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty)
Knee Arthroplasty CPT Codes
27438 Arthroplasty, patella; with prosthesis
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methyl methacrylate with or without insertion of spacer, knee
The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
- CPT codes 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) should not be reported with other knee arthroscopy codes (29866-29889). - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. |
29881 | Removal of knee cartilage using an endoscope | HCPCS | CPT Codes for Arthroscopy and Arthroplasty Knee Procedures
Knee Arthroscopy CPT codes
29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29866 – Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
29867 – Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875 (Limited synovectomy, “separate procedure”)
29876 – Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879 – Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
29884 – Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29888 – Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 – Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty)
Knee Arthroplasty CPT Codes
27438 Arthroplasty, patella; with prosthesis
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methyl methacrylate with or without insertion of spacer, knee
The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
- CPT codes 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) should not be reported with other knee arthroscopy codes (29866-29889). - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. |
29888 | Repair of anterior cruciate ligament of knee using an endoscope | HCPCS | CPT Codes for Arthroscopy and Arthroplasty Knee Procedures
Knee Arthroscopy CPT codes
29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29866 – Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
29867 – Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875 (Limited synovectomy, “separate procedure”)
29876 – Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879 – Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
29884 – Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29888 – Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 – Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty)
Knee Arthroplasty CPT Codes
27438 Arthroplasty, patella; with prosthesis
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methyl methacrylate with or without insertion of spacer, knee
The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
- CPT codes 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) should not be reported with other knee arthroscopy codes (29866-29889). - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. |
29850 | PR ARTHROSCOPY AID TX SPINE&/FX KNEE W/O FIXJ | HCPCS | CPT Codes for Arthroscopy and Arthroplasty Knee Procedures
Knee Arthroscopy CPT codes
29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29866 – Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
29867 – Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875 (Limited synovectomy, “separate procedure”)
29876 – Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879 – Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
29884 – Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29888 – Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 – Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty)
Knee Arthroplasty CPT Codes
27438 Arthroplasty, patella; with prosthesis
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methyl methacrylate with or without insertion of spacer, knee
The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
- CPT codes 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) should not be reported with other knee arthroscopy codes (29866-29889). - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. |
29882 | PR ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL | HCPCS | CPT Codes for Arthroscopy and Arthroplasty Knee Procedures
Knee Arthroscopy CPT codes
29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29866 – Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
29867 – Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875 (Limited synovectomy, “separate procedure”)
29876 – Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879 – Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
29884 – Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29888 – Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 – Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty)
Knee Arthroplasty CPT Codes
27438 Arthroplasty, patella; with prosthesis
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methyl methacrylate with or without insertion of spacer, knee
The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
- CPT codes 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) should not be reported with other knee arthroscopy codes (29866-29889). - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. |
29883 | PR ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL | HCPCS | CPT Codes for Arthroscopy and Arthroplasty Knee Procedures
Knee Arthroscopy CPT codes
29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29866 – Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
29867 – Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875 (Limited synovectomy, “separate procedure”)
29876 – Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879 – Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
29884 – Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29888 – Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 – Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty)
Knee Arthroplasty CPT Codes
27438 Arthroplasty, patella; with prosthesis
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methyl methacrylate with or without insertion of spacer, knee
The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
- CPT codes 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) should not be reported with other knee arthroscopy codes (29866-29889). - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. |
G0289 | PR ARTHRO, LOOSE BODY + CHONDRO | HCPCS | CPT Codes for Arthroscopy and Arthroplasty Knee Procedures
Knee Arthroscopy CPT codes
29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29866 – Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
29867 – Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875 (Limited synovectomy, “separate procedure”)
29876 – Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879 – Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
29884 – Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29888 – Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 – Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty)
Knee Arthroplasty CPT Codes
27438 Arthroplasty, patella; with prosthesis
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methyl methacrylate with or without insertion of spacer, knee
The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
- CPT codes 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) should not be reported with other knee arthroscopy codes (29866-29889). - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. |
29856 | Tibial arthroscopy/surgery | HCPCS | CPT Codes for Arthroscopy and Arthroplasty Knee Procedures
Knee Arthroscopy CPT codes
29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29866 – Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
29867 – Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875 (Limited synovectomy, “separate procedure”)
29876 – Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879 – Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
29884 – Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29888 – Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 – Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty)
Knee Arthroplasty CPT Codes
27438 Arthroplasty, patella; with prosthesis
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methyl methacrylate with or without insertion of spacer, knee
The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
- CPT codes 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) should not be reported with other knee arthroscopy codes (29866-29889). - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. |
29879 | PR ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX | HCPCS | CPT Codes for Arthroscopy and Arthroplasty Knee Procedures
Knee Arthroscopy CPT codes
29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29866 – Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
29867 – Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875 (Limited synovectomy, “separate procedure”)
29876 – Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879 – Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
29884 – Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29888 – Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 – Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty)
Knee Arthroplasty CPT Codes
27438 Arthroplasty, patella; with prosthesis
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methyl methacrylate with or without insertion of spacer, knee
The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
- CPT codes 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) should not be reported with other knee arthroscopy codes (29866-29889). - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. |
29851 | PR ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ | HCPCS | CPT Codes for Arthroscopy and Arthroplasty Knee Procedures
Knee Arthroscopy CPT codes
29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29866 – Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
29867 – Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875 (Limited synovectomy, “separate procedure”)
29876 – Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879 – Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
29884 – Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29888 – Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 – Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty)
Knee Arthroplasty CPT Codes
27438 Arthroplasty, patella; with prosthesis
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methyl methacrylate with or without insertion of spacer, knee
The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
- CPT codes 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) should not be reported with other knee arthroscopy codes (29866-29889). - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. |
29880 | Removal of both knee cartilages using an endoscope | HCPCS | CPT Codes for Arthroscopy and Arthroplasty Knee Procedures
Knee Arthroscopy CPT codes
29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29866 – Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
29867 – Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875 (Limited synovectomy, “separate procedure”)
29876 – Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879 – Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
29884 – Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29888 – Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 – Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty)
Knee Arthroplasty CPT Codes
27438 Arthroplasty, patella; with prosthesis
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methyl methacrylate with or without insertion of spacer, knee
The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
- CPT codes 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) should not be reported with other knee arthroscopy codes (29866-29889). - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. |
29874 | PR ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY | HCPCS | CPT Codes for Arthroscopy and Arthroplasty Knee Procedures
Knee Arthroscopy CPT codes
29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29866 – Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
29867 – Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875 (Limited synovectomy, “separate procedure”)
29876 – Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879 – Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
29884 – Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29888 – Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 – Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty)
Knee Arthroplasty CPT Codes
27438 Arthroplasty, patella; with prosthesis
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methyl methacrylate with or without insertion of spacer, knee
The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
- CPT codes 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) should not be reported with other knee arthroscopy codes (29866-29889). - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. |
29868 | PR ARTHROSCOPY KNEE MENISCAL TRNSPLJ MED/LAT | HCPCS | CPT Codes for Arthroscopy and Arthroplasty Knee Procedures
Knee Arthroscopy CPT codes
29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29866 – Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
29867 – Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875 (Limited synovectomy, “separate procedure”)
29876 – Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879 – Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
29884 – Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29888 – Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 – Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty)
Knee Arthroplasty CPT Codes
27438 Arthroplasty, patella; with prosthesis
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methyl methacrylate with or without insertion of spacer, knee
The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
- CPT codes 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) should not be reported with other knee arthroscopy codes (29866-29889). - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. |
29867 | PR ARTHROSCOPY KNEE OSTEOCHONDRAL ALLOGRAFT | HCPCS | CPT Codes for Arthroscopy and Arthroplasty Knee Procedures
Knee Arthroscopy CPT codes
29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29866 – Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
29867 – Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875 (Limited synovectomy, “separate procedure”)
29876 – Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879 – Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
29884 – Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29888 – Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 – Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty)
Knee Arthroplasty CPT Codes
27438 Arthroplasty, patella; with prosthesis
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methyl methacrylate with or without insertion of spacer, knee
The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
- CPT codes 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) should not be reported with other knee arthroscopy codes (29866-29889). - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. |
29877 | Removal or shaving of knee joint cartilage using an endoscope | HCPCS | CPT Codes for Arthroscopy and Arthroplasty Knee Procedures
Knee Arthroscopy CPT codes
29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29866 – Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
29867 – Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875 (Limited synovectomy, “separate procedure”)
29876 – Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879 – Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
29884 – Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29888 – Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 – Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty)
Knee Arthroplasty CPT Codes
27438 Arthroplasty, patella; with prosthesis
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methyl methacrylate with or without insertion of spacer, knee
The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
- CPT codes 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) should not be reported with other knee arthroscopy codes (29866-29889). - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. |
20000 | Incision of abscess | HCPCS | CPT Codes for Arthroscopy and Arthroplasty Knee Procedures
Knee Arthroscopy CPT codes
29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29866 – Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
29867 – Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875 (Limited synovectomy, “separate procedure”)
29876 – Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879 – Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
29884 – Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29888 – Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 – Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty)
Knee Arthroplasty CPT Codes
27438 Arthroplasty, patella; with prosthesis
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methyl methacrylate with or without insertion of spacer, knee
The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
- CPT codes 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) should not be reported with other knee arthroscopy codes (29866-29889). - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. |
27488 | REMOVAL PROSTHESIS | HCPCS | CPT Codes for Arthroscopy and Arthroplasty Knee Procedures
Knee Arthroscopy CPT codes
29850 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 – Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 – Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29866 – Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
29867 – Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875 (Limited synovectomy, “separate procedure”)
29876 – Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877 – Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879 – Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 – Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
29881 – Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
29882 – Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29883 – Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
29884 – Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29888 – Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 – Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
HCPCS Level II code G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty)
Knee Arthroplasty CPT Codes
27438 Arthroplasty, patella; with prosthesis
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methyl methacrylate with or without insertion of spacer, knee
The Centers for Medicare and Medicaid Services (CMS) provides the following guidance (https://www.cms.gov/files/document/chapter4cptcodes20000-29999final11.pdf) on the use of the Arthroscopic Knee Procedure CPT codes:
- CPT codes 29874 (Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) and 29877 (Arthroscopy, knee, surgical; for debridement/shaving of articular cartilage (chondroplasty)) should not be reported with other knee arthroscopy codes (29866-29889). - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. |
29881 | Removal of knee cartilage using an endoscope | HCPCS | - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. - CPT code 29876 may be reported for a medically reasonable and necessary synovectomy with another arthroscopic knee procedure on the ipsilateral knee if the synovectomy is performed in 2 compartments on which another arthroscopic procedure is not performed. |
29880 | Removal of both knee cartilages using an endoscope | HCPCS | - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. - CPT code 29876 may be reported for a medically reasonable and necessary synovectomy with another arthroscopic knee procedure on the ipsilateral knee if the synovectomy is performed in 2 compartments on which another arthroscopic procedure is not performed. |
G0289 | PR ARTHRO, LOOSE BODY + CHONDRO | HCPCS | - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. - CPT code 29876 may be reported for a medically reasonable and necessary synovectomy with another arthroscopic knee procedure on the ipsilateral knee if the synovectomy is performed in 2 compartments on which another arthroscopic procedure is not performed. |
29875 | PR ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX | HCPCS | - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. - CPT code 29876 may be reported for a medically reasonable and necessary synovectomy with another arthroscopic knee procedure on the ipsilateral knee if the synovectomy is performed in 2 compartments on which another arthroscopic procedure is not performed. |
29876 | PR ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS | HCPCS | - Since CPT codes 29880 and 29881 include debridement/shaving of articular cartilage of any compartment, HCPCS code G0289 may be reported with CPT codes 29880 or 29881 only if reported for removal of a loose body or foreign body from a different compartment of the same knee. - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. - CPT code 29876 may be reported for a medically reasonable and necessary synovectomy with another arthroscopic knee procedure on the ipsilateral knee if the synovectomy is performed in 2 compartments on which another arthroscopic procedure is not performed. |
G0289 | PR ARTHRO, LOOSE BODY + CHONDRO | HCPCS | - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. - CPT code 29876 may be reported for a medically reasonable and necessary synovectomy with another arthroscopic knee procedure on the ipsilateral knee if the synovectomy is performed in 2 compartments on which another arthroscopic procedure is not performed. A 2020 AAPC article provides further guidance:
- If chondroplasty is the only procedure performed, 29877 is the appropriate code for all payers, including Medicare. |
29875 | PR ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX | HCPCS | - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. - CPT code 29876 may be reported for a medically reasonable and necessary synovectomy with another arthroscopic knee procedure on the ipsilateral knee if the synovectomy is performed in 2 compartments on which another arthroscopic procedure is not performed. A 2020 AAPC article provides further guidance:
- If chondroplasty is the only procedure performed, 29877 is the appropriate code for all payers, including Medicare. |
29877 | Removal or shaving of knee joint cartilage using an endoscope | HCPCS | - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. - CPT code 29876 may be reported for a medically reasonable and necessary synovectomy with another arthroscopic knee procedure on the ipsilateral knee if the synovectomy is performed in 2 compartments on which another arthroscopic procedure is not performed. A 2020 AAPC article provides further guidance:
- If chondroplasty is the only procedure performed, 29877 is the appropriate code for all payers, including Medicare. |
29876 | PR ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS | HCPCS | - HCPCS code G0289 shall not be reported for removal of a loose body or foreign body or debridement/shaving of articular cartilage from the same compartment as another knee arthroscopic procedure. - Arthroscopic synovectomy of the knee may be reported with CPT codes 29875 (Limited synovectomy, “separate procedure”) or 29876 (Major synovectomy of two or three compartments). - CPT code 29875 shall not be reported with another arthroscopic knee procedure on the ipsilateral knee. - CPT code 29876 may be reported for a medically reasonable and necessary synovectomy with another arthroscopic knee procedure on the ipsilateral knee if the synovectomy is performed in 2 compartments on which another arthroscopic procedure is not performed. A 2020 AAPC article provides further guidance:
- If chondroplasty is the only procedure performed, 29877 is the appropriate code for all payers, including Medicare. |
1999 | ANESTHESIOLOGY GROUP | CPT | The fact that a Physician or other Provider has prescribed, ordered, recommended, or approved a service or supply does not in itself, make it Medically Necessary. POLICY HISTORY4/1993: Approved by Medical Policy Advisory Committee (MPAC)
2/1997: Expanded clinical indications approved by MPAC. Limited to DEXA method only, once every 12 months. 6/1999: Interim policy revision: Included use of quantitative ultrasound (QUS) as an approved method
8/1999: Addition of QUS approved by MPAC
11/2000: Reviewed by MPAC; no changes
5/21/2001: Code Reference section revised; non-covered codes table added
10/15/2001: Verbiage revised under "policy" section; "Reimbursement is not provided for SPA, DPA or QCT bone densitometry techniques" to "SPA, DPA and QCT bone densitometry techniques are considered investigational and not eligible for coverage." 2/14/2002: Investigational definition added
4/18/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 diagnosis codes 493 and 579 4th/5th digit added
3/2003: Reviewed by MPAC, frequency of all current indications changed to every 2 years except long term glucocortocoid therapy where bone density substantiates need for glucocorticoid reduction remains every 12 months, Sources updated
6/12/2003: Code Reference section updated
8/7/2003: Code Reference section updated, CPT code range 76075-76076 listed separately, fourth and fifth digit added as appropriate to 242.9, 256.3, and 556, ICD-9 diagnosis code ranges listed separately 493.00-493.92, 555.0-555.9, 579.0-579.9, 756.5-756.59, ICD-9 diagnosis codes 491.20 and 491.21 complete descriptions added
8/14/2003: CPT code 76071 added, ICD-9 diagnosis codes 227.3, V07.4 added
7/14/2004: Code Reference section updated, ICD-9 diagnosis code 491.20, 491.21, 493.00, 493.01, 493.02, 493.10, 493.11, 493.12, 493.20, 493.21, 493.22, 493.90, 493.91, 493.92, 496, 555.0, 555.1, 555.2, 555.9, 556.0, 556.1, 556.2, 556.3, 556.4, 556.5, 556.6. |
1999 | ANESTHESIOLOGY GROUP | CPT | POLICY HISTORY4/1993: Approved by Medical Policy Advisory Committee (MPAC)
2/1997: Expanded clinical indications approved by MPAC. Limited to DEXA method only, once every 12 months. 6/1999: Interim policy revision: Included use of quantitative ultrasound (QUS) as an approved method
8/1999: Addition of QUS approved by MPAC
11/2000: Reviewed by MPAC; no changes
5/21/2001: Code Reference section revised; non-covered codes table added
10/15/2001: Verbiage revised under "policy" section; "Reimbursement is not provided for SPA, DPA or QCT bone densitometry techniques" to "SPA, DPA and QCT bone densitometry techniques are considered investigational and not eligible for coverage." 2/14/2002: Investigational definition added
4/18/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 diagnosis codes 493 and 579 4th/5th digit added
3/2003: Reviewed by MPAC, frequency of all current indications changed to every 2 years except long term glucocortocoid therapy where bone density substantiates need for glucocorticoid reduction remains every 12 months, Sources updated
6/12/2003: Code Reference section updated
8/7/2003: Code Reference section updated, CPT code range 76075-76076 listed separately, fourth and fifth digit added as appropriate to 242.9, 256.3, and 556, ICD-9 diagnosis code ranges listed separately 493.00-493.92, 555.0-555.9, 579.0-579.9, 756.5-756.59, ICD-9 diagnosis codes 491.20 and 491.21 complete descriptions added
8/14/2003: CPT code 76071 added, ICD-9 diagnosis codes 227.3, V07.4 added
7/14/2004: Code Reference section updated, ICD-9 diagnosis code 491.20, 491.21, 493.00, 493.01, 493.02, 493.10, 493.11, 493.12, 493.20, 493.21, 493.22, 493.90, 493.91, 493.92, 496, 555.0, 555.1, 555.2, 555.9, 556.0, 556.1, 556.2, 556.3, 556.4, 556.5, 556.6. 556.8, 556.9, 558.9, 564.2, 571.49, 714.0 deleted
9/27/2004: Under Policy “chronic” renal failure specified, ICD-9 diagnosis code 491.20, 491.21, 493.00, 493.01, 493.02, 493.10, 493.11, 493.12, 493.20, 493.21, 493.22, 493.90, 493.91, 493.92, 496, 555.0, 555.1, 555.2, 555.9, 556.0, 556.1, 556.2, 556.3, 556.4, 556.5, 556.6, 556.8, 556.9, 558.9, 564.2, 571.49, 714.0 added to covered codes with notation “Bone density measurement, using either the QUS or DEXA technology is considered medically necessary and eligible for coverage once every 12 months for long term glucocorticoid therapy where bone density substantiates a need for glucocorticoid reduction in conditions such as listed above but not limited to the condition above. |
1999 | ANESTHESIOLOGY GROUP | CPT | Limited to DEXA method only, once every 12 months. 6/1999: Interim policy revision: Included use of quantitative ultrasound (QUS) as an approved method
8/1999: Addition of QUS approved by MPAC
11/2000: Reviewed by MPAC; no changes
5/21/2001: Code Reference section revised; non-covered codes table added
10/15/2001: Verbiage revised under "policy" section; "Reimbursement is not provided for SPA, DPA or QCT bone densitometry techniques" to "SPA, DPA and QCT bone densitometry techniques are considered investigational and not eligible for coverage." 2/14/2002: Investigational definition added
4/18/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 diagnosis codes 493 and 579 4th/5th digit added
3/2003: Reviewed by MPAC, frequency of all current indications changed to every 2 years except long term glucocortocoid therapy where bone density substantiates need for glucocorticoid reduction remains every 12 months, Sources updated
6/12/2003: Code Reference section updated
8/7/2003: Code Reference section updated, CPT code range 76075-76076 listed separately, fourth and fifth digit added as appropriate to 242.9, 256.3, and 556, ICD-9 diagnosis code ranges listed separately 493.00-493.92, 555.0-555.9, 579.0-579.9, 756.5-756.59, ICD-9 diagnosis codes 491.20 and 491.21 complete descriptions added
8/14/2003: CPT code 76071 added, ICD-9 diagnosis codes 227.3, V07.4 added
7/14/2004: Code Reference section updated, ICD-9 diagnosis code 491.20, 491.21, 493.00, 493.01, 493.02, 493.10, 493.11, 493.12, 493.20, 493.21, 493.22, 493.90, 493.91, 493.92, 496, 555.0, 555.1, 555.2, 555.9, 556.0, 556.1, 556.2, 556.3, 556.4, 556.5, 556.6. 556.8, 556.9, 558.9, 564.2, 571.49, 714.0 deleted
9/27/2004: Under Policy “chronic” renal failure specified, ICD-9 diagnosis code 491.20, 491.21, 493.00, 493.01, 493.02, 493.10, 493.11, 493.12, 493.20, 493.21, 493.22, 493.90, 493.91, 493.92, 496, 555.0, 555.1, 555.2, 555.9, 556.0, 556.1, 556.2, 556.3, 556.4, 556.5, 556.6, 556.8, 556.9, 558.9, 564.2, 571.49, 714.0 added to covered codes with notation “Bone density measurement, using either the QUS or DEXA technology is considered medically necessary and eligible for coverage once every 12 months for long term glucocorticoid therapy where bone density substantiates a need for glucocorticoid reduction in conditions such as listed above but not limited to the condition above. Note: V58.65 Long-term (current) use of steroids,” The examples of conditions listed are covered in addition to other chronic illnesses requiring the long term (current) use of glucocorticoid. |
1999 | ANESTHESIOLOGY GROUP | CPT | 6/1999: Interim policy revision: Included use of quantitative ultrasound (QUS) as an approved method
8/1999: Addition of QUS approved by MPAC
11/2000: Reviewed by MPAC; no changes
5/21/2001: Code Reference section revised; non-covered codes table added
10/15/2001: Verbiage revised under "policy" section; "Reimbursement is not provided for SPA, DPA or QCT bone densitometry techniques" to "SPA, DPA and QCT bone densitometry techniques are considered investigational and not eligible for coverage." 2/14/2002: Investigational definition added
4/18/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 diagnosis codes 493 and 579 4th/5th digit added
3/2003: Reviewed by MPAC, frequency of all current indications changed to every 2 years except long term glucocortocoid therapy where bone density substantiates need for glucocorticoid reduction remains every 12 months, Sources updated
6/12/2003: Code Reference section updated
8/7/2003: Code Reference section updated, CPT code range 76075-76076 listed separately, fourth and fifth digit added as appropriate to 242.9, 256.3, and 556, ICD-9 diagnosis code ranges listed separately 493.00-493.92, 555.0-555.9, 579.0-579.9, 756.5-756.59, ICD-9 diagnosis codes 491.20 and 491.21 complete descriptions added
8/14/2003: CPT code 76071 added, ICD-9 diagnosis codes 227.3, V07.4 added
7/14/2004: Code Reference section updated, ICD-9 diagnosis code 491.20, 491.21, 493.00, 493.01, 493.02, 493.10, 493.11, 493.12, 493.20, 493.21, 493.22, 493.90, 493.91, 493.92, 496, 555.0, 555.1, 555.2, 555.9, 556.0, 556.1, 556.2, 556.3, 556.4, 556.5, 556.6. 556.8, 556.9, 558.9, 564.2, 571.49, 714.0 deleted
9/27/2004: Under Policy “chronic” renal failure specified, ICD-9 diagnosis code 491.20, 491.21, 493.00, 493.01, 493.02, 493.10, 493.11, 493.12, 493.20, 493.21, 493.22, 493.90, 493.91, 493.92, 496, 555.0, 555.1, 555.2, 555.9, 556.0, 556.1, 556.2, 556.3, 556.4, 556.5, 556.6, 556.8, 556.9, 558.9, 564.2, 571.49, 714.0 added to covered codes with notation “Bone density measurement, using either the QUS or DEXA technology is considered medically necessary and eligible for coverage once every 12 months for long term glucocorticoid therapy where bone density substantiates a need for glucocorticoid reduction in conditions such as listed above but not limited to the condition above. Note: V58.65 Long-term (current) use of steroids,” The examples of conditions listed are covered in addition to other chronic illnesses requiring the long term (current) use of glucocorticoid. Note “but not limited to” - coding has been listed in the Code Reference section for the examples listed in the Policy section only, ICD-9 diagnosis code 242.00, 242.01, 242.10, 242.11, 242.20, 242.21, 242.30, 242.31, 242.40, 242.41, 242.80, 242.81, 756.10, 756.9 added to covered codes, ICD-9 diagnosis code 252.0 5th digit added “252.01,” ICD-9 diagnosis code 626.0 note added “Amenorrhea of six month's duration associated with extensive exercise and/or anorexia nervosa (ICD-9 diagnosis code 307.1)
3/24/2005: CPT code 76077 with effective date of 1/1/2005 added
8/26/2005: CPT code 76077 deleted
11/8/2005: Code Reference section updated, 4th digit added to ICD9 diagnosis code 585.1-585.9: description revised
03/10/2006: Coding updated. |
76075 | Dxa bone density, axial | HCPCS | 2/14/2002: Investigational definition added
4/18/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 diagnosis codes 493 and 579 4th/5th digit added
3/2003: Reviewed by MPAC, frequency of all current indications changed to every 2 years except long term glucocortocoid therapy where bone density substantiates need for glucocorticoid reduction remains every 12 months, Sources updated
6/12/2003: Code Reference section updated
8/7/2003: Code Reference section updated, CPT code range 76075-76076 listed separately, fourth and fifth digit added as appropriate to 242.9, 256.3, and 556, ICD-9 diagnosis code ranges listed separately 493.00-493.92, 555.0-555.9, 579.0-579.9, 756.5-756.59, ICD-9 diagnosis codes 491.20 and 491.21 complete descriptions added
8/14/2003: CPT code 76071 added, ICD-9 diagnosis codes 227.3, V07.4 added
7/14/2004: Code Reference section updated, ICD-9 diagnosis code 491.20, 491.21, 493.00, 493.01, 493.02, 493.10, 493.11, 493.12, 493.20, 493.21, 493.22, 493.90, 493.91, 493.92, 496, 555.0, 555.1, 555.2, 555.9, 556.0, 556.1, 556.2, 556.3, 556.4, 556.5, 556.6. 556.8, 556.9, 558.9, 564.2, 571.49, 714.0 deleted
9/27/2004: Under Policy “chronic” renal failure specified, ICD-9 diagnosis code 491.20, 491.21, 493.00, 493.01, 493.02, 493.10, 493.11, 493.12, 493.20, 493.21, 493.22, 493.90, 493.91, 493.92, 496, 555.0, 555.1, 555.2, 555.9, 556.0, 556.1, 556.2, 556.3, 556.4, 556.5, 556.6, 556.8, 556.9, 558.9, 564.2, 571.49, 714.0 added to covered codes with notation “Bone density measurement, using either the QUS or DEXA technology is considered medically necessary and eligible for coverage once every 12 months for long term glucocorticoid therapy where bone density substantiates a need for glucocorticoid reduction in conditions such as listed above but not limited to the condition above. Note: V58.65 Long-term (current) use of steroids,” The examples of conditions listed are covered in addition to other chronic illnesses requiring the long term (current) use of glucocorticoid. Note “but not limited to” - coding has been listed in the Code Reference section for the examples listed in the Policy section only, ICD-9 diagnosis code 242.00, 242.01, 242.10, 242.11, 242.20, 242.21, 242.30, 242.31, 242.40, 242.41, 242.80, 242.81, 756.10, 756.9 added to covered codes, ICD-9 diagnosis code 252.0 5th digit added “252.01,” ICD-9 diagnosis code 626.0 note added “Amenorrhea of six month's duration associated with extensive exercise and/or anorexia nervosa (ICD-9 diagnosis code 307.1)
3/24/2005: CPT code 76077 with effective date of 1/1/2005 added
8/26/2005: CPT code 76077 deleted
11/8/2005: Code Reference section updated, 4th digit added to ICD9 diagnosis code 585.1-585.9: description revised
03/10/2006: Coding updated. HCPCS 2006 revisions added to policy
09/13/2006: Coding updated. |
76071 | Ct bone density, peripheral | HCPCS | 2/14/2002: Investigational definition added
4/18/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 diagnosis codes 493 and 579 4th/5th digit added
3/2003: Reviewed by MPAC, frequency of all current indications changed to every 2 years except long term glucocortocoid therapy where bone density substantiates need for glucocorticoid reduction remains every 12 months, Sources updated
6/12/2003: Code Reference section updated
8/7/2003: Code Reference section updated, CPT code range 76075-76076 listed separately, fourth and fifth digit added as appropriate to 242.9, 256.3, and 556, ICD-9 diagnosis code ranges listed separately 493.00-493.92, 555.0-555.9, 579.0-579.9, 756.5-756.59, ICD-9 diagnosis codes 491.20 and 491.21 complete descriptions added
8/14/2003: CPT code 76071 added, ICD-9 diagnosis codes 227.3, V07.4 added
7/14/2004: Code Reference section updated, ICD-9 diagnosis code 491.20, 491.21, 493.00, 493.01, 493.02, 493.10, 493.11, 493.12, 493.20, 493.21, 493.22, 493.90, 493.91, 493.92, 496, 555.0, 555.1, 555.2, 555.9, 556.0, 556.1, 556.2, 556.3, 556.4, 556.5, 556.6. 556.8, 556.9, 558.9, 564.2, 571.49, 714.0 deleted
9/27/2004: Under Policy “chronic” renal failure specified, ICD-9 diagnosis code 491.20, 491.21, 493.00, 493.01, 493.02, 493.10, 493.11, 493.12, 493.20, 493.21, 493.22, 493.90, 493.91, 493.92, 496, 555.0, 555.1, 555.2, 555.9, 556.0, 556.1, 556.2, 556.3, 556.4, 556.5, 556.6, 556.8, 556.9, 558.9, 564.2, 571.49, 714.0 added to covered codes with notation “Bone density measurement, using either the QUS or DEXA technology is considered medically necessary and eligible for coverage once every 12 months for long term glucocorticoid therapy where bone density substantiates a need for glucocorticoid reduction in conditions such as listed above but not limited to the condition above. Note: V58.65 Long-term (current) use of steroids,” The examples of conditions listed are covered in addition to other chronic illnesses requiring the long term (current) use of glucocorticoid. Note “but not limited to” - coding has been listed in the Code Reference section for the examples listed in the Policy section only, ICD-9 diagnosis code 242.00, 242.01, 242.10, 242.11, 242.20, 242.21, 242.30, 242.31, 242.40, 242.41, 242.80, 242.81, 756.10, 756.9 added to covered codes, ICD-9 diagnosis code 252.0 5th digit added “252.01,” ICD-9 diagnosis code 626.0 note added “Amenorrhea of six month's duration associated with extensive exercise and/or anorexia nervosa (ICD-9 diagnosis code 307.1)
3/24/2005: CPT code 76077 with effective date of 1/1/2005 added
8/26/2005: CPT code 76077 deleted
11/8/2005: Code Reference section updated, 4th digit added to ICD9 diagnosis code 585.1-585.9: description revised
03/10/2006: Coding updated. HCPCS 2006 revisions added to policy
09/13/2006: Coding updated. |
76077 | Dxa bone density/v-fracture | HCPCS | 2/14/2002: Investigational definition added
4/18/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 diagnosis codes 493 and 579 4th/5th digit added
3/2003: Reviewed by MPAC, frequency of all current indications changed to every 2 years except long term glucocortocoid therapy where bone density substantiates need for glucocorticoid reduction remains every 12 months, Sources updated
6/12/2003: Code Reference section updated
8/7/2003: Code Reference section updated, CPT code range 76075-76076 listed separately, fourth and fifth digit added as appropriate to 242.9, 256.3, and 556, ICD-9 diagnosis code ranges listed separately 493.00-493.92, 555.0-555.9, 579.0-579.9, 756.5-756.59, ICD-9 diagnosis codes 491.20 and 491.21 complete descriptions added
8/14/2003: CPT code 76071 added, ICD-9 diagnosis codes 227.3, V07.4 added
7/14/2004: Code Reference section updated, ICD-9 diagnosis code 491.20, 491.21, 493.00, 493.01, 493.02, 493.10, 493.11, 493.12, 493.20, 493.21, 493.22, 493.90, 493.91, 493.92, 496, 555.0, 555.1, 555.2, 555.9, 556.0, 556.1, 556.2, 556.3, 556.4, 556.5, 556.6. 556.8, 556.9, 558.9, 564.2, 571.49, 714.0 deleted
9/27/2004: Under Policy “chronic” renal failure specified, ICD-9 diagnosis code 491.20, 491.21, 493.00, 493.01, 493.02, 493.10, 493.11, 493.12, 493.20, 493.21, 493.22, 493.90, 493.91, 493.92, 496, 555.0, 555.1, 555.2, 555.9, 556.0, 556.1, 556.2, 556.3, 556.4, 556.5, 556.6, 556.8, 556.9, 558.9, 564.2, 571.49, 714.0 added to covered codes with notation “Bone density measurement, using either the QUS or DEXA technology is considered medically necessary and eligible for coverage once every 12 months for long term glucocorticoid therapy where bone density substantiates a need for glucocorticoid reduction in conditions such as listed above but not limited to the condition above. Note: V58.65 Long-term (current) use of steroids,” The examples of conditions listed are covered in addition to other chronic illnesses requiring the long term (current) use of glucocorticoid. Note “but not limited to” - coding has been listed in the Code Reference section for the examples listed in the Policy section only, ICD-9 diagnosis code 242.00, 242.01, 242.10, 242.11, 242.20, 242.21, 242.30, 242.31, 242.40, 242.41, 242.80, 242.81, 756.10, 756.9 added to covered codes, ICD-9 diagnosis code 252.0 5th digit added “252.01,” ICD-9 diagnosis code 626.0 note added “Amenorrhea of six month's duration associated with extensive exercise and/or anorexia nervosa (ICD-9 diagnosis code 307.1)
3/24/2005: CPT code 76077 with effective date of 1/1/2005 added
8/26/2005: CPT code 76077 deleted
11/8/2005: Code Reference section updated, 4th digit added to ICD9 diagnosis code 585.1-585.9: description revised
03/10/2006: Coding updated. HCPCS 2006 revisions added to policy
09/13/2006: Coding updated. |
76076 | Dxa bone density/peripheral | HCPCS | 2/14/2002: Investigational definition added
4/18/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 diagnosis codes 493 and 579 4th/5th digit added
3/2003: Reviewed by MPAC, frequency of all current indications changed to every 2 years except long term glucocortocoid therapy where bone density substantiates need for glucocorticoid reduction remains every 12 months, Sources updated
6/12/2003: Code Reference section updated
8/7/2003: Code Reference section updated, CPT code range 76075-76076 listed separately, fourth and fifth digit added as appropriate to 242.9, 256.3, and 556, ICD-9 diagnosis code ranges listed separately 493.00-493.92, 555.0-555.9, 579.0-579.9, 756.5-756.59, ICD-9 diagnosis codes 491.20 and 491.21 complete descriptions added
8/14/2003: CPT code 76071 added, ICD-9 diagnosis codes 227.3, V07.4 added
7/14/2004: Code Reference section updated, ICD-9 diagnosis code 491.20, 491.21, 493.00, 493.01, 493.02, 493.10, 493.11, 493.12, 493.20, 493.21, 493.22, 493.90, 493.91, 493.92, 496, 555.0, 555.1, 555.2, 555.9, 556.0, 556.1, 556.2, 556.3, 556.4, 556.5, 556.6. 556.8, 556.9, 558.9, 564.2, 571.49, 714.0 deleted
9/27/2004: Under Policy “chronic” renal failure specified, ICD-9 diagnosis code 491.20, 491.21, 493.00, 493.01, 493.02, 493.10, 493.11, 493.12, 493.20, 493.21, 493.22, 493.90, 493.91, 493.92, 496, 555.0, 555.1, 555.2, 555.9, 556.0, 556.1, 556.2, 556.3, 556.4, 556.5, 556.6, 556.8, 556.9, 558.9, 564.2, 571.49, 714.0 added to covered codes with notation “Bone density measurement, using either the QUS or DEXA technology is considered medically necessary and eligible for coverage once every 12 months for long term glucocorticoid therapy where bone density substantiates a need for glucocorticoid reduction in conditions such as listed above but not limited to the condition above. Note: V58.65 Long-term (current) use of steroids,” The examples of conditions listed are covered in addition to other chronic illnesses requiring the long term (current) use of glucocorticoid. Note “but not limited to” - coding has been listed in the Code Reference section for the examples listed in the Policy section only, ICD-9 diagnosis code 242.00, 242.01, 242.10, 242.11, 242.20, 242.21, 242.30, 242.31, 242.40, 242.41, 242.80, 242.81, 756.10, 756.9 added to covered codes, ICD-9 diagnosis code 252.0 5th digit added “252.01,” ICD-9 diagnosis code 626.0 note added “Amenorrhea of six month's duration associated with extensive exercise and/or anorexia nervosa (ICD-9 diagnosis code 307.1)
3/24/2005: CPT code 76077 with effective date of 1/1/2005 added
8/26/2005: CPT code 76077 deleted
11/8/2005: Code Reference section updated, 4th digit added to ICD9 diagnosis code 585.1-585.9: description revised
03/10/2006: Coding updated. HCPCS 2006 revisions added to policy
09/13/2006: Coding updated. |
76077 | Dxa bone density/v-fracture | HCPCS | 556.8, 556.9, 558.9, 564.2, 571.49, 714.0 deleted
9/27/2004: Under Policy “chronic” renal failure specified, ICD-9 diagnosis code 491.20, 491.21, 493.00, 493.01, 493.02, 493.10, 493.11, 493.12, 493.20, 493.21, 493.22, 493.90, 493.91, 493.92, 496, 555.0, 555.1, 555.2, 555.9, 556.0, 556.1, 556.2, 556.3, 556.4, 556.5, 556.6, 556.8, 556.9, 558.9, 564.2, 571.49, 714.0 added to covered codes with notation “Bone density measurement, using either the QUS or DEXA technology is considered medically necessary and eligible for coverage once every 12 months for long term glucocorticoid therapy where bone density substantiates a need for glucocorticoid reduction in conditions such as listed above but not limited to the condition above. Note: V58.65 Long-term (current) use of steroids,” The examples of conditions listed are covered in addition to other chronic illnesses requiring the long term (current) use of glucocorticoid. Note “but not limited to” - coding has been listed in the Code Reference section for the examples listed in the Policy section only, ICD-9 diagnosis code 242.00, 242.01, 242.10, 242.11, 242.20, 242.21, 242.30, 242.31, 242.40, 242.41, 242.80, 242.81, 756.10, 756.9 added to covered codes, ICD-9 diagnosis code 252.0 5th digit added “252.01,” ICD-9 diagnosis code 626.0 note added “Amenorrhea of six month's duration associated with extensive exercise and/or anorexia nervosa (ICD-9 diagnosis code 307.1)
3/24/2005: CPT code 76077 with effective date of 1/1/2005 added
8/26/2005: CPT code 76077 deleted
11/8/2005: Code Reference section updated, 4th digit added to ICD9 diagnosis code 585.1-585.9: description revised
03/10/2006: Coding updated. HCPCS 2006 revisions added to policy
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
09/25/2006: Policy clarified and partially rewritten
10/25/2006: Code reference section updated. |
76077 | Dxa bone density/v-fracture | HCPCS | Note: V58.65 Long-term (current) use of steroids,” The examples of conditions listed are covered in addition to other chronic illnesses requiring the long term (current) use of glucocorticoid. Note “but not limited to” - coding has been listed in the Code Reference section for the examples listed in the Policy section only, ICD-9 diagnosis code 242.00, 242.01, 242.10, 242.11, 242.20, 242.21, 242.30, 242.31, 242.40, 242.41, 242.80, 242.81, 756.10, 756.9 added to covered codes, ICD-9 diagnosis code 252.0 5th digit added “252.01,” ICD-9 diagnosis code 626.0 note added “Amenorrhea of six month's duration associated with extensive exercise and/or anorexia nervosa (ICD-9 diagnosis code 307.1)
3/24/2005: CPT code 76077 with effective date of 1/1/2005 added
8/26/2005: CPT code 76077 deleted
11/8/2005: Code Reference section updated, 4th digit added to ICD9 diagnosis code 585.1-585.9: description revised
03/10/2006: Coding updated. HCPCS 2006 revisions added to policy
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
09/25/2006: Policy clarified and partially rewritten
10/25/2006: Code reference section updated. CPT code 76077 added to covered table. |
76077 | Dxa bone density/v-fracture | HCPCS | Note “but not limited to” - coding has been listed in the Code Reference section for the examples listed in the Policy section only, ICD-9 diagnosis code 242.00, 242.01, 242.10, 242.11, 242.20, 242.21, 242.30, 242.31, 242.40, 242.41, 242.80, 242.81, 756.10, 756.9 added to covered codes, ICD-9 diagnosis code 252.0 5th digit added “252.01,” ICD-9 diagnosis code 626.0 note added “Amenorrhea of six month's duration associated with extensive exercise and/or anorexia nervosa (ICD-9 diagnosis code 307.1)
3/24/2005: CPT code 76077 with effective date of 1/1/2005 added
8/26/2005: CPT code 76077 deleted
11/8/2005: Code Reference section updated, 4th digit added to ICD9 diagnosis code 585.1-585.9: description revised
03/10/2006: Coding updated. HCPCS 2006 revisions added to policy
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
09/25/2006: Policy clarified and partially rewritten
10/25/2006: Code reference section updated. CPT code 76077 added to covered table. HCPC code G0130 added to non-covered table
12/21/2006: Policy clarified. |
G0130 | Single energy x-ray study | HCPCS | Note “but not limited to” - coding has been listed in the Code Reference section for the examples listed in the Policy section only, ICD-9 diagnosis code 242.00, 242.01, 242.10, 242.11, 242.20, 242.21, 242.30, 242.31, 242.40, 242.41, 242.80, 242.81, 756.10, 756.9 added to covered codes, ICD-9 diagnosis code 252.0 5th digit added “252.01,” ICD-9 diagnosis code 626.0 note added “Amenorrhea of six month's duration associated with extensive exercise and/or anorexia nervosa (ICD-9 diagnosis code 307.1)
3/24/2005: CPT code 76077 with effective date of 1/1/2005 added
8/26/2005: CPT code 76077 deleted
11/8/2005: Code Reference section updated, 4th digit added to ICD9 diagnosis code 585.1-585.9: description revised
03/10/2006: Coding updated. HCPCS 2006 revisions added to policy
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
09/25/2006: Policy clarified and partially rewritten
10/25/2006: Code reference section updated. CPT code 76077 added to covered table. HCPC code G0130 added to non-covered table
12/21/2006: Policy clarified. |
76077 | Dxa bone density/v-fracture | HCPCS | HCPCS 2006 revisions added to policy
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
09/25/2006: Policy clarified and partially rewritten
10/25/2006: Code reference section updated. CPT code 76077 added to covered table. HCPC code G0130 added to non-covered table
12/21/2006: Policy clarified. Added "including, but not limited to, women 60 years of age or older" to women deficient in estrogen following menopause
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
12/17/2007: Coding updated.CPT/HCPCS 2008 revisions added to policy
9/17/2008: Annual ICD-9 updates effective 10-1-2008 applied
9/28/2009: Code reference section updated. |
G0130 | Single energy x-ray study | HCPCS | HCPCS 2006 revisions added to policy
09/13/2006: Coding updated. ICD9 2006 revisions added to policy
09/25/2006: Policy clarified and partially rewritten
10/25/2006: Code reference section updated. CPT code 76077 added to covered table. HCPC code G0130 added to non-covered table
12/21/2006: Policy clarified. Added "including, but not limited to, women 60 years of age or older" to women deficient in estrogen following menopause
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
12/17/2007: Coding updated.CPT/HCPCS 2008 revisions added to policy
9/17/2008: Annual ICD-9 updates effective 10-1-2008 applied
9/28/2009: Code reference section updated. |
76077 | Dxa bone density/v-fracture | HCPCS | ICD9 2006 revisions added to policy
09/25/2006: Policy clarified and partially rewritten
10/25/2006: Code reference section updated. CPT code 76077 added to covered table. HCPC code G0130 added to non-covered table
12/21/2006: Policy clarified. Added "including, but not limited to, women 60 years of age or older" to women deficient in estrogen following menopause
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
12/17/2007: Coding updated.CPT/HCPCS 2008 revisions added to policy
9/17/2008: Annual ICD-9 updates effective 10-1-2008 applied
9/28/2009: Code reference section updated. New ICD-9 diagnosis code 569.71 added to covered table. |
G0130 | Single energy x-ray study | HCPCS | ICD9 2006 revisions added to policy
09/25/2006: Policy clarified and partially rewritten
10/25/2006: Code reference section updated. CPT code 76077 added to covered table. HCPC code G0130 added to non-covered table
12/21/2006: Policy clarified. Added "including, but not limited to, women 60 years of age or older" to women deficient in estrogen following menopause
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
12/17/2007: Coding updated.CPT/HCPCS 2008 revisions added to policy
9/17/2008: Annual ICD-9 updates effective 10-1-2008 applied
9/28/2009: Code reference section updated. New ICD-9 diagnosis code 569.71 added to covered table. |
76075 | Dxa bone density, axial | HCPCS | CPT code 76077 added to covered table. HCPC code G0130 added to non-covered table
12/21/2006: Policy clarified. Added "including, but not limited to, women 60 years of age or older" to women deficient in estrogen following menopause
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
12/17/2007: Coding updated.CPT/HCPCS 2008 revisions added to policy
9/17/2008: Annual ICD-9 updates effective 10-1-2008 applied
9/28/2009: Code reference section updated. New ICD-9 diagnosis code 569.71 added to covered table. CPT codes 76075 and 76076 deleted from covered table due to codes were deleted as of 12-31-2006. |
76077 | Dxa bone density/v-fracture | HCPCS | CPT code 76077 added to covered table. HCPC code G0130 added to non-covered table
12/21/2006: Policy clarified. Added "including, but not limited to, women 60 years of age or older" to women deficient in estrogen following menopause
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
12/17/2007: Coding updated.CPT/HCPCS 2008 revisions added to policy
9/17/2008: Annual ICD-9 updates effective 10-1-2008 applied
9/28/2009: Code reference section updated. New ICD-9 diagnosis code 569.71 added to covered table. CPT codes 76075 and 76076 deleted from covered table due to codes were deleted as of 12-31-2006. |
G0130 | Single energy x-ray study | HCPCS | CPT code 76077 added to covered table. HCPC code G0130 added to non-covered table
12/21/2006: Policy clarified. Added "including, but not limited to, women 60 years of age or older" to women deficient in estrogen following menopause
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
12/17/2007: Coding updated.CPT/HCPCS 2008 revisions added to policy
9/17/2008: Annual ICD-9 updates effective 10-1-2008 applied
9/28/2009: Code reference section updated. New ICD-9 diagnosis code 569.71 added to covered table. CPT codes 76075 and 76076 deleted from covered table due to codes were deleted as of 12-31-2006. |
76076 | Dxa bone density/peripheral | HCPCS | CPT code 76077 added to covered table. HCPC code G0130 added to non-covered table
12/21/2006: Policy clarified. Added "including, but not limited to, women 60 years of age or older" to women deficient in estrogen following menopause
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
12/17/2007: Coding updated.CPT/HCPCS 2008 revisions added to policy
9/17/2008: Annual ICD-9 updates effective 10-1-2008 applied
9/28/2009: Code reference section updated. New ICD-9 diagnosis code 569.71 added to covered table. CPT codes 76075 and 76076 deleted from covered table due to codes were deleted as of 12-31-2006. |
76075 | Dxa bone density, axial | HCPCS | HCPC code G0130 added to non-covered table
12/21/2006: Policy clarified. Added "including, but not limited to, women 60 years of age or older" to women deficient in estrogen following menopause
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
12/17/2007: Coding updated.CPT/HCPCS 2008 revisions added to policy
9/17/2008: Annual ICD-9 updates effective 10-1-2008 applied
9/28/2009: Code reference section updated. New ICD-9 diagnosis code 569.71 added to covered table. CPT codes 76075 and 76076 deleted from covered table due to codes were deleted as of 12-31-2006. HCPC code Q9952 deleted from covered table due to code was deleted as of 12-31-2007. |
Q9952 | Inj Gad-base MR contrast,1ml | HCPCS | HCPC code G0130 added to non-covered table
12/21/2006: Policy clarified. Added "including, but not limited to, women 60 years of age or older" to women deficient in estrogen following menopause
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
12/17/2007: Coding updated.CPT/HCPCS 2008 revisions added to policy
9/17/2008: Annual ICD-9 updates effective 10-1-2008 applied
9/28/2009: Code reference section updated. New ICD-9 diagnosis code 569.71 added to covered table. CPT codes 76075 and 76076 deleted from covered table due to codes were deleted as of 12-31-2006. HCPC code Q9952 deleted from covered table due to code was deleted as of 12-31-2007. |
G0130 | Single energy x-ray study | HCPCS | HCPC code G0130 added to non-covered table
12/21/2006: Policy clarified. Added "including, but not limited to, women 60 years of age or older" to women deficient in estrogen following menopause
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
12/17/2007: Coding updated.CPT/HCPCS 2008 revisions added to policy
9/17/2008: Annual ICD-9 updates effective 10-1-2008 applied
9/28/2009: Code reference section updated. New ICD-9 diagnosis code 569.71 added to covered table. CPT codes 76075 and 76076 deleted from covered table due to codes were deleted as of 12-31-2006. HCPC code Q9952 deleted from covered table due to code was deleted as of 12-31-2007. |
76076 | Dxa bone density/peripheral | HCPCS | HCPC code G0130 added to non-covered table
12/21/2006: Policy clarified. Added "including, but not limited to, women 60 years of age or older" to women deficient in estrogen following menopause
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
12/17/2007: Coding updated.CPT/HCPCS 2008 revisions added to policy
9/17/2008: Annual ICD-9 updates effective 10-1-2008 applied
9/28/2009: Code reference section updated. New ICD-9 diagnosis code 569.71 added to covered table. CPT codes 76075 and 76076 deleted from covered table due to codes were deleted as of 12-31-2006. HCPC code Q9952 deleted from covered table due to code was deleted as of 12-31-2007. |
76075 | Dxa bone density, axial | HCPCS | Added "including, but not limited to, women 60 years of age or older" to women deficient in estrogen following menopause
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
12/17/2007: Coding updated.CPT/HCPCS 2008 revisions added to policy
9/17/2008: Annual ICD-9 updates effective 10-1-2008 applied
9/28/2009: Code reference section updated. New ICD-9 diagnosis code 569.71 added to covered table. CPT codes 76075 and 76076 deleted from covered table due to codes were deleted as of 12-31-2006. HCPC code Q9952 deleted from covered table due to code was deleted as of 12-31-2007. 12/22/2009: Title revised to include “Mineral.” Description Section updated to add Quantitative Computed Tomography (QCT) and Ultrasound Densitometry, removed Quantitative Ultrasound. |
Q9952 | Inj Gad-base MR contrast,1ml | HCPCS | Added "including, but not limited to, women 60 years of age or older" to women deficient in estrogen following menopause
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
12/17/2007: Coding updated.CPT/HCPCS 2008 revisions added to policy
9/17/2008: Annual ICD-9 updates effective 10-1-2008 applied
9/28/2009: Code reference section updated. New ICD-9 diagnosis code 569.71 added to covered table. CPT codes 76075 and 76076 deleted from covered table due to codes were deleted as of 12-31-2006. HCPC code Q9952 deleted from covered table due to code was deleted as of 12-31-2007. 12/22/2009: Title revised to include “Mineral.” Description Section updated to add Quantitative Computed Tomography (QCT) and Ultrasound Densitometry, removed Quantitative Ultrasound. |
76076 | Dxa bone density/peripheral | HCPCS | Added "including, but not limited to, women 60 years of age or older" to women deficient in estrogen following menopause
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
12/17/2007: Coding updated.CPT/HCPCS 2008 revisions added to policy
9/17/2008: Annual ICD-9 updates effective 10-1-2008 applied
9/28/2009: Code reference section updated. New ICD-9 diagnosis code 569.71 added to covered table. CPT codes 76075 and 76076 deleted from covered table due to codes were deleted as of 12-31-2006. HCPC code Q9952 deleted from covered table due to code was deleted as of 12-31-2007. 12/22/2009: Title revised to include “Mineral.” Description Section updated to add Quantitative Computed Tomography (QCT) and Ultrasound Densitometry, removed Quantitative Ultrasound. |
A9500 | TECHNETIUM TC 99M SESTAMIBI IV KIT | HCPCS | Scintimammography, breast-specific gamma imaging (BSGI), and molecular breast imaging (MBI) are considered investigational in all applications, including but not limited to their use as an adjunct to mammography or in staging the axillary lymph nodes. Preoperative or intraoperative sentinel lymph node detection using handheld or mounted mobile gamma cameras is considered investigational. The most commonly used radiopharmaceutical used in for BSGI or MBI is technetium Tc 99m sestamibi (marketed by Draxis Specialty Pharmaceuticals Inc., Cardinal Health 414, LLC, Mallinckrodt Inc., and Pharmalucence, Inc.). There is a specific HCPCS code for this radiopharmaceutical:
A9500: Technetium Tc-99m sestamibi, diagnostic, per study dose, up to 40 millicuries. BlueCard/National Account Issues
State or federal mandates (e.g., FEP) may dictate that all FDA-approved devices may not be considered investigational and thus these devices may be assessed only on the basis of their medical necessity. |
A9500 | TECHNETIUM TC 99M SESTAMIBI IV KIT | HCPCS | Preoperative or intraoperative sentinel lymph node detection using handheld or mounted mobile gamma cameras is considered investigational. The most commonly used radiopharmaceutical used in for BSGI or MBI is technetium Tc 99m sestamibi (marketed by Draxis Specialty Pharmaceuticals Inc., Cardinal Health 414, LLC, Mallinckrodt Inc., and Pharmalucence, Inc.). There is a specific HCPCS code for this radiopharmaceutical:
A9500: Technetium Tc-99m sestamibi, diagnostic, per study dose, up to 40 millicuries. BlueCard/National Account Issues
State or federal mandates (e.g., FEP) may dictate that all FDA-approved devices may not be considered investigational and thus these devices may be assessed only on the basis of their medical necessity. This policy was created in January 1998 and updated periodically with literature review. |
G0504 | INIT/SUBSQ PS CCM EA ADD 30 MN CAL MO BHC MGR AC | HCPCS | Providers should take care to order urine lab testing only when it is medically necessary and provides a corresponding benefit to the care and treatment of the patient. Urinalysis CPT Codes Urinalysis methods used by diagnostic laboratories include visual examination, reagent strip screening, refractometry for specific gravity, and microscopic inspection of centrifuged sediment. New CPT Codes for Behavioral Health Services in 2018. Starting January 2017, the Centers for Medicare and Medicaid Services (CMS) approved payment for services provided to patients with behavioral health disorders who are participating in psychiatric collaborative care programs or are receiving behavioral health integration services. Medical coding companies utilized the three CMS approved HCPCS codes – G0502, G0503 and G0504 – for billing these services. |
G0502 | Init psych care manag, 70min | HCPCS | Providers should take care to order urine lab testing only when it is medically necessary and provides a corresponding benefit to the care and treatment of the patient. Urinalysis CPT Codes Urinalysis methods used by diagnostic laboratories include visual examination, reagent strip screening, refractometry for specific gravity, and microscopic inspection of centrifuged sediment. New CPT Codes for Behavioral Health Services in 2018. Starting January 2017, the Centers for Medicare and Medicaid Services (CMS) approved payment for services provided to patients with behavioral health disorders who are participating in psychiatric collaborative care programs or are receiving behavioral health integration services. Medical coding companies utilized the three CMS approved HCPCS codes – G0502, G0503 and G0504 – for billing these services. |
G0503 | SUBSQT PS CCM 1ST 60 MIN SUBSQT MO BEH HC MGR AC | HCPCS | Providers should take care to order urine lab testing only when it is medically necessary and provides a corresponding benefit to the care and treatment of the patient. Urinalysis CPT Codes Urinalysis methods used by diagnostic laboratories include visual examination, reagent strip screening, refractometry for specific gravity, and microscopic inspection of centrifuged sediment. New CPT Codes for Behavioral Health Services in 2018. Starting January 2017, the Centers for Medicare and Medicaid Services (CMS) approved payment for services provided to patients with behavioral health disorders who are participating in psychiatric collaborative care programs or are receiving behavioral health integration services. Medical coding companies utilized the three CMS approved HCPCS codes – G0502, G0503 and G0504 – for billing these services. |
G0504 | INIT/SUBSQ PS CCM EA ADD 30 MN CAL MO BHC MGR AC | HCPCS | Urinalysis CPT Codes Urinalysis methods used by diagnostic laboratories include visual examination, reagent strip screening, refractometry for specific gravity, and microscopic inspection of centrifuged sediment. New CPT Codes for Behavioral Health Services in 2018. Starting January 2017, the Centers for Medicare and Medicaid Services (CMS) approved payment for services provided to patients with behavioral health disorders who are participating in psychiatric collaborative care programs or are receiving behavioral health integration services. Medical coding companies utilized the three CMS approved HCPCS codes – G0502, G0503 and G0504 – for billing these services. In 2018, new CPT codes replace the 2017 HCPCS codes for Collaborative Care Management-Behavioral Health Integration (CoCM-BHI). |
G0502 | Init psych care manag, 70min | HCPCS | Urinalysis CPT Codes Urinalysis methods used by diagnostic laboratories include visual examination, reagent strip screening, refractometry for specific gravity, and microscopic inspection of centrifuged sediment. New CPT Codes for Behavioral Health Services in 2018. Starting January 2017, the Centers for Medicare and Medicaid Services (CMS) approved payment for services provided to patients with behavioral health disorders who are participating in psychiatric collaborative care programs or are receiving behavioral health integration services. Medical coding companies utilized the three CMS approved HCPCS codes – G0502, G0503 and G0504 – for billing these services. In 2018, new CPT codes replace the 2017 HCPCS codes for Collaborative Care Management-Behavioral Health Integration (CoCM-BHI). |
G0503 | SUBSQT PS CCM 1ST 60 MIN SUBSQT MO BEH HC MGR AC | HCPCS | Urinalysis CPT Codes Urinalysis methods used by diagnostic laboratories include visual examination, reagent strip screening, refractometry for specific gravity, and microscopic inspection of centrifuged sediment. New CPT Codes for Behavioral Health Services in 2018. Starting January 2017, the Centers for Medicare and Medicaid Services (CMS) approved payment for services provided to patients with behavioral health disorders who are participating in psychiatric collaborative care programs or are receiving behavioral health integration services. Medical coding companies utilized the three CMS approved HCPCS codes – G0502, G0503 and G0504 – for billing these services. In 2018, new CPT codes replace the 2017 HCPCS codes for Collaborative Care Management-Behavioral Health Integration (CoCM-BHI). |
99494 | PR 1ST/SBSQ PSYCH COLLAB CARE MGMT EA ADDL 30 MINS | HCPCS | New CPT Codes for Behavioral Health Services in 2018. Starting January 2017, the Centers for Medicare and Medicaid Services (CMS) approved payment for services provided to patients with behavioral health disorders who are participating in psychiatric collaborative care programs or are receiving behavioral health integration services. Medical coding companies utilized the three CMS approved HCPCS codes – G0502, G0503 and G0504 – for billing these services. In 2018, new CPT codes replace the 2017 HCPCS codes for Collaborative Care Management-Behavioral Health Integration (CoCM-BHI). The three new CPT codes to report psychiatric collaborative care management (PCCM) in starting January 1, 2018 are: 99492, 99493 and 99494. |
99493 | Sbsq psyc collab care mgmt | HCPCS | New CPT Codes for Behavioral Health Services in 2018. Starting January 2017, the Centers for Medicare and Medicaid Services (CMS) approved payment for services provided to patients with behavioral health disorders who are participating in psychiatric collaborative care programs or are receiving behavioral health integration services. Medical coding companies utilized the three CMS approved HCPCS codes – G0502, G0503 and G0504 – for billing these services. In 2018, new CPT codes replace the 2017 HCPCS codes for Collaborative Care Management-Behavioral Health Integration (CoCM-BHI). The three new CPT codes to report psychiatric collaborative care management (PCCM) in starting January 1, 2018 are: 99492, 99493 and 99494. |
G0503 | SUBSQT PS CCM 1ST 60 MIN SUBSQT MO BEH HC MGR AC | HCPCS | New CPT Codes for Behavioral Health Services in 2018. Starting January 2017, the Centers for Medicare and Medicaid Services (CMS) approved payment for services provided to patients with behavioral health disorders who are participating in psychiatric collaborative care programs or are receiving behavioral health integration services. Medical coding companies utilized the three CMS approved HCPCS codes – G0502, G0503 and G0504 – for billing these services. In 2018, new CPT codes replace the 2017 HCPCS codes for Collaborative Care Management-Behavioral Health Integration (CoCM-BHI). The three new CPT codes to report psychiatric collaborative care management (PCCM) in starting January 1, 2018 are: 99492, 99493 and 99494. |
99492 | PR 1ST PSYCHIATRIC COLLAB CARE MGMT 1ST 70 MINS | HCPCS | New CPT Codes for Behavioral Health Services in 2018. Starting January 2017, the Centers for Medicare and Medicaid Services (CMS) approved payment for services provided to patients with behavioral health disorders who are participating in psychiatric collaborative care programs or are receiving behavioral health integration services. Medical coding companies utilized the three CMS approved HCPCS codes – G0502, G0503 and G0504 – for billing these services. In 2018, new CPT codes replace the 2017 HCPCS codes for Collaborative Care Management-Behavioral Health Integration (CoCM-BHI). The three new CPT codes to report psychiatric collaborative care management (PCCM) in starting January 1, 2018 are: 99492, 99493 and 99494. |
G0504 | INIT/SUBSQ PS CCM EA ADD 30 MN CAL MO BHC MGR AC | HCPCS | New CPT Codes for Behavioral Health Services in 2018. Starting January 2017, the Centers for Medicare and Medicaid Services (CMS) approved payment for services provided to patients with behavioral health disorders who are participating in psychiatric collaborative care programs or are receiving behavioral health integration services. Medical coding companies utilized the three CMS approved HCPCS codes – G0502, G0503 and G0504 – for billing these services. In 2018, new CPT codes replace the 2017 HCPCS codes for Collaborative Care Management-Behavioral Health Integration (CoCM-BHI). The three new CPT codes to report psychiatric collaborative care management (PCCM) in starting January 1, 2018 are: 99492, 99493 and 99494. |
G0502 | Init psych care manag, 70min | HCPCS | New CPT Codes for Behavioral Health Services in 2018. Starting January 2017, the Centers for Medicare and Medicaid Services (CMS) approved payment for services provided to patients with behavioral health disorders who are participating in psychiatric collaborative care programs or are receiving behavioral health integration services. Medical coding companies utilized the three CMS approved HCPCS codes – G0502, G0503 and G0504 – for billing these services. In 2018, new CPT codes replace the 2017 HCPCS codes for Collaborative Care Management-Behavioral Health Integration (CoCM-BHI). The three new CPT codes to report psychiatric collaborative care management (PCCM) in starting January 1, 2018 are: 99492, 99493 and 99494. |
99494 | PR 1ST/SBSQ PSYCH COLLAB CARE MGMT EA ADDL 30 MINS | HCPCS | Starting January 2017, the Centers for Medicare and Medicaid Services (CMS) approved payment for services provided to patients with behavioral health disorders who are participating in psychiatric collaborative care programs or are receiving behavioral health integration services. Medical coding companies utilized the three CMS approved HCPCS codes – G0502, G0503 and G0504 – for billing these services. In 2018, new CPT codes replace the 2017 HCPCS codes for Collaborative Care Management-Behavioral Health Integration (CoCM-BHI). The three new CPT codes to report psychiatric collaborative care management (PCCM) in starting January 1, 2018 are: 99492, 99493 and 99494. Reporting CPT Codes 99492-99494 Psychiatric collaborative care management (PCCM) as described by Current Procedural Terminology (CPT) 2018 reflects behavioral health services delivered via a specific evidence-based model. |
99493 | Sbsq psyc collab care mgmt | HCPCS | Starting January 2017, the Centers for Medicare and Medicaid Services (CMS) approved payment for services provided to patients with behavioral health disorders who are participating in psychiatric collaborative care programs or are receiving behavioral health integration services. Medical coding companies utilized the three CMS approved HCPCS codes – G0502, G0503 and G0504 – for billing these services. In 2018, new CPT codes replace the 2017 HCPCS codes for Collaborative Care Management-Behavioral Health Integration (CoCM-BHI). The three new CPT codes to report psychiatric collaborative care management (PCCM) in starting January 1, 2018 are: 99492, 99493 and 99494. Reporting CPT Codes 99492-99494 Psychiatric collaborative care management (PCCM) as described by Current Procedural Terminology (CPT) 2018 reflects behavioral health services delivered via a specific evidence-based model. |
G0503 | SUBSQT PS CCM 1ST 60 MIN SUBSQT MO BEH HC MGR AC | HCPCS | Starting January 2017, the Centers for Medicare and Medicaid Services (CMS) approved payment for services provided to patients with behavioral health disorders who are participating in psychiatric collaborative care programs or are receiving behavioral health integration services. Medical coding companies utilized the three CMS approved HCPCS codes – G0502, G0503 and G0504 – for billing these services. In 2018, new CPT codes replace the 2017 HCPCS codes for Collaborative Care Management-Behavioral Health Integration (CoCM-BHI). The three new CPT codes to report psychiatric collaborative care management (PCCM) in starting January 1, 2018 are: 99492, 99493 and 99494. Reporting CPT Codes 99492-99494 Psychiatric collaborative care management (PCCM) as described by Current Procedural Terminology (CPT) 2018 reflects behavioral health services delivered via a specific evidence-based model. |
99492 | PR 1ST PSYCHIATRIC COLLAB CARE MGMT 1ST 70 MINS | HCPCS | Starting January 2017, the Centers for Medicare and Medicaid Services (CMS) approved payment for services provided to patients with behavioral health disorders who are participating in psychiatric collaborative care programs or are receiving behavioral health integration services. Medical coding companies utilized the three CMS approved HCPCS codes – G0502, G0503 and G0504 – for billing these services. In 2018, new CPT codes replace the 2017 HCPCS codes for Collaborative Care Management-Behavioral Health Integration (CoCM-BHI). The three new CPT codes to report psychiatric collaborative care management (PCCM) in starting January 1, 2018 are: 99492, 99493 and 99494. Reporting CPT Codes 99492-99494 Psychiatric collaborative care management (PCCM) as described by Current Procedural Terminology (CPT) 2018 reflects behavioral health services delivered via a specific evidence-based model. |
G0504 | INIT/SUBSQ PS CCM EA ADD 30 MN CAL MO BHC MGR AC | HCPCS | Starting January 2017, the Centers for Medicare and Medicaid Services (CMS) approved payment for services provided to patients with behavioral health disorders who are participating in psychiatric collaborative care programs or are receiving behavioral health integration services. Medical coding companies utilized the three CMS approved HCPCS codes – G0502, G0503 and G0504 – for billing these services. In 2018, new CPT codes replace the 2017 HCPCS codes for Collaborative Care Management-Behavioral Health Integration (CoCM-BHI). The three new CPT codes to report psychiatric collaborative care management (PCCM) in starting January 1, 2018 are: 99492, 99493 and 99494. Reporting CPT Codes 99492-99494 Psychiatric collaborative care management (PCCM) as described by Current Procedural Terminology (CPT) 2018 reflects behavioral health services delivered via a specific evidence-based model. |
G0502 | Init psych care manag, 70min | HCPCS | Starting January 2017, the Centers for Medicare and Medicaid Services (CMS) approved payment for services provided to patients with behavioral health disorders who are participating in psychiatric collaborative care programs or are receiving behavioral health integration services. Medical coding companies utilized the three CMS approved HCPCS codes – G0502, G0503 and G0504 – for billing these services. In 2018, new CPT codes replace the 2017 HCPCS codes for Collaborative Care Management-Behavioral Health Integration (CoCM-BHI). The three new CPT codes to report psychiatric collaborative care management (PCCM) in starting January 1, 2018 are: 99492, 99493 and 99494. Reporting CPT Codes 99492-99494 Psychiatric collaborative care management (PCCM) as described by Current Procedural Terminology (CPT) 2018 reflects behavioral health services delivered via a specific evidence-based model. |
99494 | PR 1ST/SBSQ PSYCH COLLAB CARE MGMT EA ADDL 30 MINS | HCPCS | Medical coding companies utilized the three CMS approved HCPCS codes – G0502, G0503 and G0504 – for billing these services. In 2018, new CPT codes replace the 2017 HCPCS codes for Collaborative Care Management-Behavioral Health Integration (CoCM-BHI). The three new CPT codes to report psychiatric collaborative care management (PCCM) in starting January 1, 2018 are: 99492, 99493 and 99494. Reporting CPT Codes 99492-99494 Psychiatric collaborative care management (PCCM) as described by Current Procedural Terminology (CPT) 2018 reflects behavioral health services delivered via a specific evidence-based model. PCCM code Critical Role of Primary Care Clinicians in PCCM. |
99493 | Sbsq psyc collab care mgmt | HCPCS | Medical coding companies utilized the three CMS approved HCPCS codes – G0502, G0503 and G0504 – for billing these services. In 2018, new CPT codes replace the 2017 HCPCS codes for Collaborative Care Management-Behavioral Health Integration (CoCM-BHI). The three new CPT codes to report psychiatric collaborative care management (PCCM) in starting January 1, 2018 are: 99492, 99493 and 99494. Reporting CPT Codes 99492-99494 Psychiatric collaborative care management (PCCM) as described by Current Procedural Terminology (CPT) 2018 reflects behavioral health services delivered via a specific evidence-based model. PCCM code Critical Role of Primary Care Clinicians in PCCM. |
G0503 | SUBSQT PS CCM 1ST 60 MIN SUBSQT MO BEH HC MGR AC | HCPCS | Medical coding companies utilized the three CMS approved HCPCS codes – G0502, G0503 and G0504 – for billing these services. In 2018, new CPT codes replace the 2017 HCPCS codes for Collaborative Care Management-Behavioral Health Integration (CoCM-BHI). The three new CPT codes to report psychiatric collaborative care management (PCCM) in starting January 1, 2018 are: 99492, 99493 and 99494. Reporting CPT Codes 99492-99494 Psychiatric collaborative care management (PCCM) as described by Current Procedural Terminology (CPT) 2018 reflects behavioral health services delivered via a specific evidence-based model. PCCM code Critical Role of Primary Care Clinicians in PCCM. |
99492 | PR 1ST PSYCHIATRIC COLLAB CARE MGMT 1ST 70 MINS | HCPCS | Medical coding companies utilized the three CMS approved HCPCS codes – G0502, G0503 and G0504 – for billing these services. In 2018, new CPT codes replace the 2017 HCPCS codes for Collaborative Care Management-Behavioral Health Integration (CoCM-BHI). The three new CPT codes to report psychiatric collaborative care management (PCCM) in starting January 1, 2018 are: 99492, 99493 and 99494. Reporting CPT Codes 99492-99494 Psychiatric collaborative care management (PCCM) as described by Current Procedural Terminology (CPT) 2018 reflects behavioral health services delivered via a specific evidence-based model. PCCM code Critical Role of Primary Care Clinicians in PCCM. |
G0504 | INIT/SUBSQ PS CCM EA ADD 30 MN CAL MO BHC MGR AC | HCPCS | Medical coding companies utilized the three CMS approved HCPCS codes – G0502, G0503 and G0504 – for billing these services. In 2018, new CPT codes replace the 2017 HCPCS codes for Collaborative Care Management-Behavioral Health Integration (CoCM-BHI). The three new CPT codes to report psychiatric collaborative care management (PCCM) in starting January 1, 2018 are: 99492, 99493 and 99494. Reporting CPT Codes 99492-99494 Psychiatric collaborative care management (PCCM) as described by Current Procedural Terminology (CPT) 2018 reflects behavioral health services delivered via a specific evidence-based model. PCCM code Critical Role of Primary Care Clinicians in PCCM. |
G0502 | Init psych care manag, 70min | HCPCS | Medical coding companies utilized the three CMS approved HCPCS codes – G0502, G0503 and G0504 – for billing these services. In 2018, new CPT codes replace the 2017 HCPCS codes for Collaborative Care Management-Behavioral Health Integration (CoCM-BHI). The three new CPT codes to report psychiatric collaborative care management (PCCM) in starting January 1, 2018 are: 99492, 99493 and 99494. Reporting CPT Codes 99492-99494 Psychiatric collaborative care management (PCCM) as described by Current Procedural Terminology (CPT) 2018 reflects behavioral health services delivered via a specific evidence-based model. PCCM code Critical Role of Primary Care Clinicians in PCCM. |
99494 | PR 1ST/SBSQ PSYCH COLLAB CARE MGMT EA ADDL 30 MINS | HCPCS | In 2018, new CPT codes replace the 2017 HCPCS codes for Collaborative Care Management-Behavioral Health Integration (CoCM-BHI). The three new CPT codes to report psychiatric collaborative care management (PCCM) in starting January 1, 2018 are: 99492, 99493 and 99494. Reporting CPT Codes 99492-99494 Psychiatric collaborative care management (PCCM) as described by Current Procedural Terminology (CPT) 2018 reflects behavioral health services delivered via a specific evidence-based model. PCCM code Critical Role of Primary Care Clinicians in PCCM. Coding Musculoskeletal Ultrasound Guided Procedures. |
99493 | Sbsq psyc collab care mgmt | HCPCS | In 2018, new CPT codes replace the 2017 HCPCS codes for Collaborative Care Management-Behavioral Health Integration (CoCM-BHI). The three new CPT codes to report psychiatric collaborative care management (PCCM) in starting January 1, 2018 are: 99492, 99493 and 99494. Reporting CPT Codes 99492-99494 Psychiatric collaborative care management (PCCM) as described by Current Procedural Terminology (CPT) 2018 reflects behavioral health services delivered via a specific evidence-based model. PCCM code Critical Role of Primary Care Clinicians in PCCM. Coding Musculoskeletal Ultrasound Guided Procedures. |
99492 | PR 1ST PSYCHIATRIC COLLAB CARE MGMT 1ST 70 MINS | HCPCS | In 2018, new CPT codes replace the 2017 HCPCS codes for Collaborative Care Management-Behavioral Health Integration (CoCM-BHI). The three new CPT codes to report psychiatric collaborative care management (PCCM) in starting January 1, 2018 are: 99492, 99493 and 99494. Reporting CPT Codes 99492-99494 Psychiatric collaborative care management (PCCM) as described by Current Procedural Terminology (CPT) 2018 reflects behavioral health services delivered via a specific evidence-based model. PCCM code Critical Role of Primary Care Clinicians in PCCM. Coding Musculoskeletal Ultrasound Guided Procedures. |
1745 | Thoracoscopic robotic assisted procedure | ICD | PMID 17141745. - World Health Organisation. (1992). The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. Geneva: World Health Organisation. |
G0472 | PR HEP C SCREEN HIGH RISK/OTHER | HCPCS | The evidence collected led the USPSTF to issue a B recommendation for HCV screening in all adults aged 18-79 years in the draft statement. The task force also suggests that physicians consider screening patients for HCV who are aged younger than 18 years and older than 79 years if they are at high risk for infection. The USPSTF is accepting comments on the draft recommendation statement and draft evidence review on screening adults for HCV infection until Sept. 23. The task force will consider all comments received as they prepare the final recommendation. How to Code HCV Screening
When coding HCV screening, use HCPCS Level II code G0472, Hepatitis C antibody screening, for individual at high risk and other covered indication(s). |
G0472 | PR HEP C SCREEN HIGH RISK/OTHER | HCPCS | The USPSTF is accepting comments on the draft recommendation statement and draft evidence review on screening adults for HCV infection until Sept. 23. The task force will consider all comments received as they prepare the final recommendation. How to Code HCV Screening
When coding HCV screening, use HCPCS Level II code G0472, Hepatitis C antibody screening, for individual at high risk and other covered indication(s). - For high-risk groups, the HCPCS Level II code must be accompanied by ICD-10 code Z72.89 Other problems related to lifestyle. - For age-related screenings, report Z11.59 Encounter for screening for other viral diseases. |
G0472 | PR HEP C SCREEN HIGH RISK/OTHER | HCPCS | The task force will consider all comments received as they prepare the final recommendation. How to Code HCV Screening
When coding HCV screening, use HCPCS Level II code G0472, Hepatitis C antibody screening, for individual at high risk and other covered indication(s). - For high-risk groups, the HCPCS Level II code must be accompanied by ICD-10 code Z72.89 Other problems related to lifestyle. - For age-related screenings, report Z11.59 Encounter for screening for other viral diseases. Refer to Gilead Sciences’ Hepatitis C ICD-10 code list for additional ICD-10 codes frequently used in the management of patients with HCV. |
G0472 | PR HEP C SCREEN HIGH RISK/OTHER | HCPCS | How to Code HCV Screening
When coding HCV screening, use HCPCS Level II code G0472, Hepatitis C antibody screening, for individual at high risk and other covered indication(s). - For high-risk groups, the HCPCS Level II code must be accompanied by ICD-10 code Z72.89 Other problems related to lifestyle. - For age-related screenings, report Z11.59 Encounter for screening for other viral diseases. Refer to Gilead Sciences’ Hepatitis C ICD-10 code list for additional ICD-10 codes frequently used in the management of patients with HCV. |
82465 | HC CHOLESTEROL LEVEL W/DIRECT LDL | HCPCS | Code 33871’s descriptor better describes the way the procedure is performed now. Medicare Coverage of Screening for Heart Disease
There are two Medicare-covered preventative services for heart disease screening per national coverage determination (NCD) 210.11: “Cardiovascular Disease Screening Tests” and “Intensive Behavioral Therapy (IBT) for Cardiovascular Disease (CVD).”
If you are a Medicare patient and don’t have apparent signs or symptoms of CVD, you are still covered once every five years for cardiovascular disease screening tests. These tests are reported using CPT® code:
80061 Lipid panel
This panel must include the following:
Cholesterol, serum, total (82465)
Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) (83718)
ICD-10-CM code Z13.6 Encounter for screening for cardiovascular disorders supports 80061; however, other codes may apply, as well. To see Change Requests (CRs) specific to individual ICD-10 codes for screening for cardiovascular disorders, go to the Centers for Medicare & Medicaid Services’ (CMS) Medicare Coverage – General Information ICD-10 webpage. According to NCD 210.11, IBT for CVD is covered annually for Medicare patients “who are competent and alert at the time counseling is provided” and if the counseling is furnished “by a qualified primary care physician or other primary care practitioner in a primary care setting.” Coding for the CVD risk reduction visit includes HCPCS Level II G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes. |
33871 | Transvrs a-arch grf hypthrm | HCPCS | Code 33871’s descriptor better describes the way the procedure is performed now. Medicare Coverage of Screening for Heart Disease
There are two Medicare-covered preventative services for heart disease screening per national coverage determination (NCD) 210.11: “Cardiovascular Disease Screening Tests” and “Intensive Behavioral Therapy (IBT) for Cardiovascular Disease (CVD).”
If you are a Medicare patient and don’t have apparent signs or symptoms of CVD, you are still covered once every five years for cardiovascular disease screening tests. These tests are reported using CPT® code:
80061 Lipid panel
This panel must include the following:
Cholesterol, serum, total (82465)
Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) (83718)
ICD-10-CM code Z13.6 Encounter for screening for cardiovascular disorders supports 80061; however, other codes may apply, as well. To see Change Requests (CRs) specific to individual ICD-10 codes for screening for cardiovascular disorders, go to the Centers for Medicare & Medicaid Services’ (CMS) Medicare Coverage – General Information ICD-10 webpage. According to NCD 210.11, IBT for CVD is covered annually for Medicare patients “who are competent and alert at the time counseling is provided” and if the counseling is furnished “by a qualified primary care physician or other primary care practitioner in a primary care setting.” Coding for the CVD risk reduction visit includes HCPCS Level II G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes. |
80061 | TTH LIPID-SP | HCPCS | Code 33871’s descriptor better describes the way the procedure is performed now. Medicare Coverage of Screening for Heart Disease
There are two Medicare-covered preventative services for heart disease screening per national coverage determination (NCD) 210.11: “Cardiovascular Disease Screening Tests” and “Intensive Behavioral Therapy (IBT) for Cardiovascular Disease (CVD).”
If you are a Medicare patient and don’t have apparent signs or symptoms of CVD, you are still covered once every five years for cardiovascular disease screening tests. These tests are reported using CPT® code:
80061 Lipid panel
This panel must include the following:
Cholesterol, serum, total (82465)
Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) (83718)
ICD-10-CM code Z13.6 Encounter for screening for cardiovascular disorders supports 80061; however, other codes may apply, as well. To see Change Requests (CRs) specific to individual ICD-10 codes for screening for cardiovascular disorders, go to the Centers for Medicare & Medicaid Services’ (CMS) Medicare Coverage – General Information ICD-10 webpage. According to NCD 210.11, IBT for CVD is covered annually for Medicare patients “who are competent and alert at the time counseling is provided” and if the counseling is furnished “by a qualified primary care physician or other primary care practitioner in a primary care setting.” Coding for the CVD risk reduction visit includes HCPCS Level II G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes. |
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