SUBCHONDROPLASTY (SCP ) PROCEDURE CODING …

1 SUBCHONDROPLASTY (SCP ) PROCEDURE CODING reference GUIDEPHYSICIAN CODING - KNEECPT Codes1 CPT Description29855 Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)29856 Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)27599 Unlisted PROCEDURE , femur or knee29999 Unlisted PROCEDURE , arthroscopyPHYSICIAN CODING - ANKLECPT Codes CPT Description29892 Arthroscopically aided repair of large osteochondritis dissecans lesion, talar dome fracture, or tibial plafond fracture, with or without internal fixation (includes arthroscopy)

2 27899 Unlisted PROCEDURE , leg or ankle29999 Unlisted PROCEDURE , arthroscopyPHYSICIAN CODING - HIP27299 Unlisted PROCEDURE , pelvis or hip joint If the PROCEDURE is performed on a joint other than knee, ankle or hip an unlisted code may be appropriate. When a minimally invasive or percutaneous SUBCHONDROPLASTY PROCEDURE is performed to treat subchondral bone defects associated with chronic bone marrow lesions of the knee report code 27599. CPT Assistant January 2014 When SUBCHONDROPLASTY is performed with a concomitant PROCEDURE SCP is inherent to the larger PROCEDURE performed and not separately coded.

3 CPT Assistant December 2012 If the SCP PROCEDURE was a separate and distinct PROCEDURE and documentation supports the additional work an additional code may be HOSPITAL AND FREE-STANDING ASC CPT CodesCPT DescriptionOPPS Status IndicatorAPC GroupAmbulatory Surgery Center Payment Indicator29855 Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)T0042A229856 Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)T0042A229892 Arthroscopically aided repair of large osteochondritis dissecans lesion, talar dome fracture, or tibial plafond fracture, with or without internal fixation (includes arthroscopy)T0051A227599 Unlisted PROCEDURE , femur or kneeT012927899 Unlisted PROCEDURE , leg or ankleT012927299 Unlisted PROCEDURE , pelvis or hip jointT012929999 Unlisted PROCEDURE , arthroscopyT0041 Status indicators (T) Multiple PROCEDURE reductions apply;Payment indicators (A2) Surgical PROCEDURE on ASC list in CY 2007.

4 Payment based on OPPS relative payment Rev. C1. Current Procedural Terminology (CPT ) copyright 2013 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical CODING reference guide DisclaimerThe information in this document was obtained from third party sources and is subject to change without notice, including as a result in changes in reimbursement laws, regulations, rules and policies. All content in this document is informational only, general in nature and does not cover all situations or all payers rules or policies. The service and the product must be reasonable and necessary for the care of the patient to support reimbursement.

5 Providers should report the PROCEDURE and related codes that most accurately describe the patients medical condition, procedures performed and the products used. This document represents no promise or guarantee by Zimmer regarding coverage or payment for products or procedures by Medicare or other payers. Providers should check Medicare bulletins, manuals, program memoranda, and Medicare guidelines to ensure compliance with Medicare requirements. Inquiries can be directed to the hospital s Medicare Part A fiscal intermediary, the physician s Medicare Part B carrier, or to appropriate payers. Zimmer specifically disclaims liability or responsibility for the results or consequences of any actions taken in reliance on information in this guide .

6 For further assistance with CODING questions, contact the Zimmer Reimbursement Hotline at 866-946-0444 Imaging procedures should generally not be reported with a specific PROCEDURE code, however if an unlisted code is reported use of an imaging code may be CODECPT Description 77002-26*Fluoroscopic guidance for needle placement ( , biopsy, aspiration, injection, localization device)*Professional componentHCPCS CODEHCPCS Description C1713 Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)C-codes report devices used in conjunction with outpatient procedures billed and paid for under Medicare HOPPS (outpatient procedures only)