**Knee Arthroscopy CPT Codes: Comprehensive Billing & Coding Guide**

Introduction

Knee arthroscopy is a minimally invasive procedure used to diagnose and treat various knee joint conditions, such as meniscal tears, ligament injuries, and cartilage damage. Proper CPT coding is essential for accurate reimbursement and to avoid denials due to incorrect bundling or modifier use. This guide will cover the key CPT codes for knee arthroscopy, common billing challenges, and how to properly document procedures for successful claims.

Understanding Knee Arthroscopy CPT Codes

Arthroscopic knee procedures range from simple diagnostic exams to complex repairs of multiple structures. The correct CPT code depends on the specific procedure performed, such as meniscectomy, synovectomy, or ligament reconstruction.

CPT Codes for Knee Arthroscopy: Breakdown & Comparison

Primary Diagnostic & Therapeutic Arthroscopy Codes

  • 29870 – Arthroscopy, knee, diagnostic, with or without synovial biopsy.

    • Used for diagnostic knee arthroscopies without additional repairs.
    • Documentation tip: If a repair is performed, diagnostic arthroscopy (29870) is bundled and should not be billed separately.

  • 29874 – Arthroscopy, knee, with removal of loose body or foreign body.

    • Used when large loose bodies (e.g., bone fragments, cartilage debris) are removed arthroscopically.

Meniscectomy & Meniscal Repair Codes

  • 29880 – Arthroscopy, knee, with meniscectomy (medial AND lateral).

    • Used when both medial and lateral menisci are partially or completely removed.

  • 29881 – Arthroscopy, knee, with meniscectomy (medial OR lateral).

    • Used when only one meniscus is removed (either medial or lateral).

  • 29882 – Arthroscopy, knee, with meniscal repair (medial OR lateral).

    • Used for 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.

Cartilage & Ligament Repair Codes

  • 29875 – Arthroscopy, knee, synovectomy (limited).

    • Used for small synovial tissue removals within a limited area.

  • 29876 – Arthroscopy, knee, synovectomy (major, two or more compartments).

    • Used for extensive synovial tissue removal across multiple compartments.

  • 29877 – Arthroscopy, knee, chondroplasty.

    • Used for cartilage debridement (not considered a repair procedure).

  • 29888 – Arthroscopy, anterior cruciate ligament (ACL) reconstruction.

    • Used for ACL reconstruction, whether autograft or allograft.

  • 29889 – Arthroscopy, posterior cruciate ligament (PCL) reconstruction.

    • Used for PCL reconstruction, similar to ACL procedures.

Billing Guidelines & Modifier Usage

  • Common Modifiers:

    • -RT/-LT – Identifies right or left knee.
    • -59 – Used when multiple arthroscopic procedures are performed and NOT bundled.
    • -51 – Multiple procedure reduction if necessary.

  • Bundling Considerations:

    • 29870 (diagnostic) is bundled if another surgical arthroscopy (e.g., 29881) is performed.
    • Meniscectomy (29880) and meniscal repair (29882) are mutually exclusive—if both are performed on the same meniscus, only the repair is billable.

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 pre-op MRI findings and failed conservative treatments.
  • Modifier Issues: Always append -59 modifier when performing distinct procedures on different structures.

Final CPT Code Table: Descriptions & RVUs

CPT Code Description RVU
29870 Diagnostic knee arthroscopy 6.48
29874 Arthroscopy, removal of loose body 7.11
29875 Arthroscopy, limited synovectomy 7.49
29876 Arthroscopy, major synovectomy 10.52
29877 Arthroscopy, chondroplasty 9.21
29880 Arthroscopy, meniscectomy (both medial & lateral) 9.03
29881 Arthroscopy, meniscectomy (medial OR lateral) 8.21
29882 Arthroscopy, meniscal repair (medial OR lateral) 9.50
29883 Arthroscopy, meniscal repair (both medial & lateral) 10.85
29888 Arthroscopy, ACL reconstruction 13.90
29889 Arthroscopy, PCL reconstruction 14.21

Conclusion

Accurate coding for knee arthroscopy procedures ensures proper reimbursement and compliance. Using the correct CPT codes, avoiding bundling errors, and applying proper modifiers will help prevent claim denials.

If this guide was helpful, explore our other orthopedic coding guides on ACL repair, hip replacement, and rotator cuff surgery!