Arthroscopy, knee, surgical; with meniscectomy (medial or lateral, including for pathologic shredding) including meniscal debridement
Audit Defense & Denial Intelligence
Research-based denial patterns from OrbDoc Bill Analyzer
1. ACL reconstruction billed without graft documentation or technique details
Common29888 (arthroscopy knee, ACL reconstruction) requires documentation of: ACL tear confirmed, graft source (autograft/allograft), tunnels created, graft passed and fixed. High-value procedure - heavily audited. Denied when documentation incomplete or when ACL repair (different code) confused with reconstruction.
Common Causes
- • Graft source not documented - autograft (hamstring/patellar) vs allograft required
- • Tunnel placement not described - femoral and tibial tunnels required for reconstruction
- • Fixation method not documented - interference screws, buttons, etc.
Resolution Strategy
Document complete reconstruction: 'Complete ACL tear confirmed arthroscopically. Hamstring autograft harvested (semitendinosus and gracilis tendons). Femoral and tibial bone tunnels created using guide. Graft passed through tunnels and tensioned. Fixed with interference screws femoral and tibial sides. Lachman test negative post-fixation.' Must document: ACL tear, graft type and source, tunnel creation, graft passage, fixation method, stability testing. Cannot appeal without complete reconstruction documentation.
Relative Value Units (RVUs)
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Clinical Information
When to Use
For arthroscopic removal or debridement of medial or lateral meniscus (not both) for degenerative or traumatic pathology
Common Scenarios
Documentation Requirements
- Meniscal pathology location and type
- Meniscectomy extent
- Debridement performed
- Articular cartilage assessment
- Post-operative plan
Coding Guidelines
Common Modifiers
Bundling Rules
- Includes diagnostic arthroscopy
- Includes meniscal debridement
- Cartilage procedures coded separately
Exclusions
- Both medial AND lateral uses 29881
- Meniscal repair uses different codes
- Isolated debridement without meniscectomy uses different code
Coding Notes
Clinical scenarios
- Meniscal pathology location and type
- Meniscectomy extent
- Debridement performed
- Meniscal pathology location and type
- Meniscectomy extent
- Debridement performed
- Meniscal pathology location and type
- Meniscectomy extent
- Debridement performed
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Code Details
Medicare Pricing
PFSRVU Breakdown
OPPS Details
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Ask a QuestionFrequently Asked Questions
CPT 29888 is the billing code for "Arthroscopy, knee, surgical; with meniscectomy (medial or lateral, including for pathologic shredding) including meniscal debridement". For arthroscopic removal or debridement of medial or lateral meniscus (not both) for degenerative or traumatic pathology
Medicare pays approximately $957.46 for CPT 29888 (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 29888 has a total RVU of 16.55, broken down as: Work RVU 7.45, Practice Expense RVU 8.39, and Malpractice RVU 0.71. RVUs (Relative Value Units) determine Medicare reimbursement rates.
The most common denial reason for CPT 29888 is "ACL reconstruction billed without graft documentation or technique details". 29888 (arthroscopy knee, ACL reconstruction) requires documentation of: ACL tear confirmed, graft source (autograft/allograft), tunnels created, graft passed and fixed. High-value procedure - heavily audited. Denied when documentation incomplete or when ACL repair (different code) confused with reconstruction. Common causes include: Graft source not documented - autograft (hamstring/patellar) vs allograft required; Tunnel placement not described - femoral and tibial tunnels required for reconstruction. Appeal success rate is approximately 70-80%.
Key documentation requirements for CPT 29888 include: Meniscal pathology location and type; Meniscectomy extent; Debridement performed; Articular cartilage assessment. Missing or incomplete documentation is a leading cause of claim denials for this code.
Bundling considerations for CPT 29888: Includes diagnostic arthroscopy. Includes meniscal debridement Use an NCCI bundling checker to verify specific code combinations before billing.
Common modifiers for CPT 29888 include: 76 (Repeat procedure by same physician), 77 (Repeat procedure by different physician), 50 (Bilateral if both knees). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.
The typical time requirement for CPT 29888 is 45-60 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.