Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
Audit Defense & Denial Intelligence
Research-based denial patterns from OrbDoc Bill Analyzer
1. Knee arthroscopy meniscectomy billed without documented meniscal tear
Very Common29881 (arthroscopy knee, meniscectomy medial/lateral) requires documentation of meniscal tear with tissue removal. Denied when diagnostic scope upgraded to meniscectomy without tear documented, or when meniscus trimmed/debrided without true tear excision. Must document tear location, size, excision performed.
Common Causes
- • Documentation states 'knee arthroscopy, meniscus debrided' - debridement not same as meniscectomy
- • Small meniscal fraying trimmed - may not qualify as meniscectomy requiring 29881
- • MRI shows meniscal tear but operative report doesn't confirm tear visualized
Resolution Strategy
Document meniscal tear and excision: 'Arthroscopic examination revealed bucket-handle tear of medial meniscus, posterior horn. Partial meniscectomy performed removing torn segment, stable rim preserved. Approximately 30% of posterior horn meniscus excised.' Must show: tear identified and described, excision performed (not just trimming), amount removed. If only diagnostic scope or minor trimming, rebill as 29870 (diagnostic) or appropriate lower code.
💬 Plain Language Explanation
What this means
This is knee arthroscopy with surgical repair - a minimally invasive procedure where a doctor uses a small camera to look inside your knee and repair damaged tissue.
Why you might see this
This is a common orthopedic procedure. You might see this if you had knee surgery to repair torn cartilage, ligaments, or other knee problems. Arthroscopy is less invasive than open knee surgery.
Common context
Common minimally invasive knee surgery for repairing torn cartilage, ligaments, or other knee problems.
What to ask your provider
"'What was repaired in my knee? What's my recovery timeline? When can I return to normal activities?'"
Relative Value Units (RVUs)
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Clinical Information
When to Use
For surgical knee arthroscopy with meniscectomy of medial OR lateral meniscus
Common Scenarios
Documentation Requirements
- Indication for meniscectomy
- Location and type of meniscal tear
- Which meniscus (medial or lateral)
- Extent of meniscectomy
- Any complications
Coding Guidelines
Common Modifiers
Bundling Rules
- Includes surgical arthroscopy
- Includes meniscectomy of medial OR lateral meniscus
- Includes meniscal shaving
- Diagnostic arthroscopy bundled when performed same session
- Meniscectomy repair coded separately
Exclusions
- 29880 (arthroscopy, knee, surgical; meniscectomy, medial AND lateral)
- 29882 (arthroscopy, knee, surgical; meniscus repair, medial OR lateral)
- 29883 (arthroscopy, knee, surgical; meniscus repair, medial AND lateral)
- 29870 (arthroscopy, knee, diagnostic)
Coding Notes
Clinical scenarios
- Indication for meniscectomy
- Location and type of meniscal tear
- Which meniscus (medial or lateral)
- Indication for meniscectomy
- Location and type of meniscal tear
- Which meniscus (medial or lateral)
- Indication for meniscectomy
- Location and type of meniscal tear
- Which meniscus (medial or lateral)
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Code Details
Medicare Pricing
PFSRVU Breakdown
OPPS Details
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Ask a QuestionFrequently Asked Questions
CPT 29881 is the billing code for "Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)". For surgical knee arthroscopy with meniscectomy of medial OR lateral meniscus
Medicare pays approximately $538.25 for CPT 29881 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.
CPT 29881 has a total RVU of 25.60, broken down as: Work RVU 11.00, Practice Expense RVU 13.50, and Malpractice RVU 1.10. RVUs (Relative Value Units) determine Medicare reimbursement rates.
The most common denial reason for CPT 29881 is "Knee arthroscopy meniscectomy billed without documented meniscal tear". 29881 (arthroscopy knee, meniscectomy medial/lateral) requires documentation of meniscal tear with tissue removal. Denied when diagnostic scope upgraded to meniscectomy without tear documented, or when meniscus trimmed/debrided without true tear excision. Must document tear location, size, excision performed. Common causes include: Documentation states 'knee arthroscopy, meniscus debrided' - debridement not same as meniscectomy; Small meniscal fraying trimmed - may not qualify as meniscectomy requiring 29881. Appeal success rate is approximately 40-60%.
Key documentation requirements for CPT 29881 include: Indication for meniscectomy; Location and type of meniscal tear; Which meniscus (medial or lateral); Extent of meniscectomy. Missing or incomplete documentation is a leading cause of claim denials for this code.
Bundling considerations for CPT 29881: Includes surgical arthroscopy. Includes meniscectomy of medial OR lateral meniscus Use an NCCI bundling checker to verify specific code combinations before billing.
Common modifiers for CPT 29881 include: 50 (Bilateral procedure when both knees performed same session), 51 (Multiple procedures performed same session), LT (Left side procedure). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.
The typical time requirement for CPT 29881 is 45-75 minutes typical operative time. Time-based codes require documentation of the actual time spent providing the service.