Knee arthroscopy with knee arthrotomy and meniscectomy (separate procedure), medial or lateral (including meniscal debridement)
Audit Defense & Denial Intelligence
Research-based denial patterns from OrbDoc Bill Analyzer
1. Medial/lateral release billed without documented patellar maltracking
Common29889 (arthroscopy knee, tibial/fibular nerve neuroplasty) is actually for medial/lateral retinacular release for patellar instability. Requires documentation of patellar maltracking, subluxation, or tilt requiring release. Denied when release performed without clear indication or when diagnostic scope upgraded without procedure documented.
Common Causes
- • No documentation of patellar tracking issues or instability
- • Release mentioned but not described in detail (extent, location)
- • Billed for routine arthroscopy without actual release performed
Resolution Strategy
Document patellar maltracking and release: 'Arthroscopic examination revealed lateral patellar tilt and maltracking with knee flexion. Lateral retinacular release performed, dividing lateral retinaculum from superolateral pole to inferior pole of patella. Post-release, patellar tracking centralized, no subluxation with flexion/extension.' Must document: patellar maltracking/instability, release procedure and extent, improved tracking post-release. If no patellar instability or release not performed, cannot bill 29889.
Relative Value Units (RVUs)
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Clinical Information
When to Use
For knee arthroscopy with conversion to arthrotomy (open approach) for meniscectomy when arthroscopic removal cannot be completed
Common Scenarios
Documentation Requirements
- Initial arthroscopic findings
- Reason for conversion to arthrotomy
- Arthrotomy incision location and size
- Meniscectomy findings and extent
- Closure technique
Coding Guidelines
Common Modifiers
Bundling Rules
- Includes both arthroscopic and open components
- Suture removal included
- Post-op care per standard protocol
Exclusions
- Pure arthroscopic meniscectomy uses simpler codes
- Isolated arthrotomy uses different codes
- Multiple joint procedures coded separately
Coding Notes
Clinical scenarios
- Initial arthroscopic findings
- Reason for conversion to arthrotomy
- Arthrotomy incision location and size
- Initial arthroscopic findings
- Reason for conversion to arthrotomy
- Arthrotomy incision location and size
- Initial arthroscopic findings
- Reason for conversion to arthrotomy
- Arthrotomy incision location and size
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Code Details
Medicare Pricing
PFSRVU Breakdown
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Ask a QuestionFrequently Asked Questions
CPT 29889 is the billing code for "Knee arthroscopy with knee arthrotomy and meniscectomy (separate procedure), medial or lateral (including meniscal debridement)". For knee arthroscopy with conversion to arthrotomy (open approach) for meniscectomy when arthroscopic removal cannot be completed
Medicare pays approximately $1207.82 for CPT 29889 (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 29889 has a total RVU of 21.73, broken down as: Work RVU 9.78, Practice Expense RVU 11.02, and Malpractice RVU 0.93. RVUs (Relative Value Units) determine Medicare reimbursement rates.
The most common denial reason for CPT 29889 is "Medial/lateral release billed without documented patellar maltracking". 29889 (arthroscopy knee, tibial/fibular nerve neuroplasty) is actually for medial/lateral retinacular release for patellar instability. Requires documentation of patellar maltracking, subluxation, or tilt requiring release. Denied when release performed without clear indication or when diagnostic scope upgraded without procedure documented. Common causes include: No documentation of patellar tracking issues or instability; Release mentioned but not described in detail (extent, location). Appeal success rate is approximately 40-60%.
Key documentation requirements for CPT 29889 include: Initial arthroscopic findings; Reason for conversion to arthrotomy; Arthrotomy incision location and size; Meniscectomy findings and extent. Missing or incomplete documentation is a leading cause of claim denials for this code.
Bundling considerations for CPT 29889: Includes both arthroscopic and open components. Suture removal included Use an NCCI bundling checker to verify specific code combinations before billing.
Common modifiers for CPT 29889 include: 22 (Increased complexity due to conversion), 76 (Repeat procedure by same physician), 50 (Bilateral if both knees). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.
The typical time requirement for CPT 29889 is 90-120 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.