Introduction
Anterior cruciate ligament (ACL) and meniscus injuries are common in sports medicine and often require surgical intervention. Proper CPT coding ensures accurate reimbursement and prevents claim denials due to bundling errors or incorrect modifier usage. This guide covers the key CPT codes for ACL reconstruction and meniscus repair, along with billing guidelines, modifier use, and a final reference table including CPT descriptions and RVUs.
Understanding ACL & Meniscus Surgery
ACL reconstruction involves replacing a torn ligament using an autograft or allograft. Meniscus surgery can include meniscectomy (removal of damaged meniscus tissue) or meniscal repair (suturing the meniscus back together). These procedures often occur together, requiring precise CPT coding.
CPT Codes for ACL & Meniscus Repair
ACL Reconstruction CPT Codes
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29888 – Arthroscopically aided anterior cruciate ligament (ACL) reconstruction.
- Used for ACL reconstruction with an autograft or allograft.
- Bundling considerations: Cannot be billed separately with meniscectomy in most cases.
-
29889 – Arthroscopically aided posterior cruciate ligament (PCL) reconstruction.
- Used when PCL reconstruction is performed instead of ACL.
Meniscus Surgery CPT Codes
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29880 – Arthroscopy, knee, with meniscectomy (medial AND lateral).
- Used when both medial and lateral menisci are removed.
-
29881 – Arthroscopy, knee, with meniscectomy (medial OR lateral).
- Used when only one meniscus is removed.
-
29882 – Arthroscopy, knee, with meniscal repair (medial OR lateral).
- Used when suturing or repairing a meniscus rather than removing it.
-
29883 – Arthroscopy, knee, with meniscal repair (medial AND lateral).
- Used when both menisci are repaired during the same session.
Other Related Knee Arthroscopy Codes
- 29875 – Arthroscopy, knee, synovectomy (limited).
- 29876 – Arthroscopy, knee, synovectomy (major, two or more compartments).
- 29877 – Arthroscopy, knee, chondroplasty.
Billing Guidelines & Modifier Usage
-
Common Modifiers:
- -RT/-LT – Identifies right or left knee.
- -59 – Used when reporting separately billable procedures.
- -51 – Applied when multiple surgeries are performed at the same session.
-
Bundling Considerations:
- ACL reconstruction (29888) and meniscectomy (29880/29881) are often bundled—verify payer policies before billing both.
- Use modifier -59 if both ACL reconstruction and meniscal repair are performed.
Common Denials & How to Avoid Them
- Bundling Errors: Verify CCI edits to determine if codes can be reported together.
- Lack of Medical Necessity: Ensure documentation includes MRI findings and failed conservative treatments.
- Modifier Issues: Always append -59 modifier when reporting distinct procedures.
Final CPT Code Table: Descriptions & RVUs
| CPT Code | Description | RVU |
|---|---|---|
| 29888 | Arthroscopically aided ACL reconstruction | 13.90 |
| 29889 | Arthroscopically aided PCL reconstruction | 14.21 |
| 29880 | Arthroscopy, knee, with meniscectomy (both medial & lateral) | 9.03 |
| 29881 | Arthroscopy, knee, with meniscectomy (medial OR lateral) | 8.21 |
| 29882 | Arthroscopy, knee, with meniscal repair (medial OR lateral) | 9.50 |
| 29883 | Arthroscopy, knee, with meniscal repair (both medial & lateral) | 10.85 |
| 29875 | Arthroscopy, knee, synovectomy (limited) | 7.49 |
| 29876 | Arthroscopy, knee, synovectomy (major) | 10.52 |
| 29877 | Arthroscopy, knee, chondroplasty | 9.21 |
Conclusion
Accurate CPT coding for ACL reconstruction and meniscus repair is essential for maximizing reimbursement and reducing denials. Understanding bundling rules, modifier application, and payer-specific guidelines will help ensure accurate claims.
If this guide was useful, check out our other orthopedic CPT coding guides on knee arthroscopy, rotator cuff repair, and spinal fusion!
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