Separate Procedure Billing

Separate Procedure Billing

April 29, 2021

I am new to coding and have a question. I remember studying about “separate procedures” and have my first operative note that includes a code that has this in the code definition. The surgeon performed a diagnostic arthroscopy (CPT code 29870) and confirmed the meniscal tear prior to proceeding with the planned meniscectomy and chondroplasty.

Does this separate procedure mean we can bill it in addition the meniscectomy CPT code, or it is included?

Thanks for your question. CPT code 29870 Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure) is as you say a ‘separate procedure’ designated code. In your scenario, this means that the diagnostic arthroscopy is inclusive to the meniscectomy performed on the same knee during the same operative session and is not separately reportable. If the surgeon had performed a left knee meniscectomy and a right knee diagnostic arthroscopy, both services would be reportable with RT and LT modifiers to differentiate them.

*This response is based on the best information available as of 04/29/21.




2021 E/M Guidelines for Orthopaedics
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