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Medicare CPT1 Codes
The following possible CPT1 codes may be used for a diagnostic arthroscopy:
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| Procedure Description |
CPT1
Code |
| Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)2 |
29870 |
| Arthroscopy, shoulder, diagnostic, with or without synovial biopsy (seperate procedure)2 |
29805 |
| Arthroscopy, elbow, diagnostic, with or without synovial biopsy (separate procedure)2 |
29830 |
| Arthroscopy, metacarpophalangeal joint, diagnostic, includes synovial biopsy2 |
29900 |
| Arthroscopy, hip, diagnostic, with or without synovial biopsy (separate procedure)2 |
29860 |
| Arthroscopy, wrist, diagnostic, with or without synovial biopsy (separate procedure)2 |
29840 |
| Arthroscopy, temporomandibular joint, diagnostic, with or without synovial biopsy (separate procedure)2 |
29800 |
- CPT is a trademark of the American Medical Association.
- CPT 2004 Professional Edition, American Medical Association, p. 113-116.
There is no specific CPT code for diagnostic arthroscopy of the ankle. However, CPT code 29999, “Unlisted procedure, arthroscopy” may be used to report this procedure. Providers who bill CPT code 29999 must provide additional information to the payor regarding the procedure performed, its medical appropriateness, and the appropriate payment rate for it. According to the AMA, “Pertinent information should include an adequate definition or description of the nature, extent, and need for the procedure, and the time, effort, and equipment necessary to provide the service.” Additional items which may be included are: complexity of symptoms, pertinent physical findings, follow-up care, final diagnosis, and diagnostic and therapeutic procedures. [CPT 2004 Professional Edition, American Medical Association, p. 46] Claims for unlisted procedures are processed manually.
THE INFORMATION PROVIDED IS GENERAL REIMBURSEMENT INFORMATION ONLY; IT IS NOT ADVICE ABOUT HOW TO CODE, COMPLETE OR SUBMIT ANY PARTICULAR CLAIM FOR PAYMENT. ALTHOUGH WE SUPPLY THIS INFORMATION TO THE BEST OF OUR KNOWLEDGE, IT IS ALWAYS THE PROVIDER’S RESPONSIBILITY TO DETERMINE AND SUBMIT APPROPRIATE CODES, CHARGES, MODIFIERS AND BILLS FOR THE SERVICES THAT WERE RENDERED. PAYORS OR THEIR LOCAL BRANCHES MAY HAVE THEIR OWN CODING AND REIMBURSEMENT REQUIREMENTS. BEFORE FILING ANY CLAIMS, PROVIDERS SHOULD VERIFY THESE REQUIREMENTS WITH THE PAYOR.
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