2025 CPT code 29805
(Active) Effective Date: N/A Revision Date: N/A Surgery - Arthroscopy Musculoskeletal System Feed
Diagnostic arthroscopy of the shoulder joint, with or without synovial biopsy.
Modifiers may be necessary depending on circumstances, such as modifier 59 for distinct procedural service if surgical procedures are performed during this diagnostic arthroscopy.Other applicable modifiers may include 51 (multiple procedures), 76 (repeat procedure), or others as clinically indicated.
Medical necessity for a diagnostic arthroscopy is established when other less invasive methods (e.g., imaging studies) fail to provide a definitive diagnosis of a shoulder condition causing pain and/or functional limitations.The need for a biopsy would be determined based on the arthroscopic findings.
The physician or qualified healthcare professional performs the arthroscopy, including insertion and removal of the arthroscope and any instruments, irrigation of the joint, and closure of the incisions.If a biopsy is performed, this responsibility also includes obtaining and processing the biopsy specimen.
In simple words: The doctor uses a small camera (arthroscope) to look inside the shoulder joint to find the source of pain or limited movement.A small tissue sample (biopsy) might also be taken for testing.
This CPT code encompasses a diagnostic arthroscopic examination of the shoulder joint. The procedure involves the insertion of an arthroscope through small incisions to visualize the joint structures.A synovial biopsy may be performed as part of this procedure, but it is reported separately.The procedure includes the insertion and removal of the arthroscope, irrigation, and closure of the incisions.Note that surgical procedures performed during this diagnostic arthroscopy are reported with separate codes, often with modifier 59.
Example 1: A patient presents with shoulder pain and limited range of motion. A diagnostic arthroscopy (29805) is performed to evaluate the joint for possible causes such as arthritis, labral tear, or rotator cuff injury. The findings may lead to additional procedures., A patient experiences persistent shoulder pain after a previous injury. A diagnostic arthroscopy (29805) with a synovial biopsy is performed to assess the joint's condition and determine the presence of inflammation or other pathological conditions., Preoperative planning for a shoulder surgery involves a diagnostic arthroscopy (29805) to rule out other conditions and confirm the surgical diagnosis before proceeding to the surgical intervention. A synovial biopsy could assist in diagnosis.
** The use of this code requires clear clinical documentation of the diagnostic findings. If the arthroscopy leads to additional surgical procedures, they should be coded separately, with the appropriate modifier (e.g., modifier 59).
- Revenue Code: P5B (Ambulatory Procedures - Musculoskeletal)
- RVU: This information is not available in the provided source and varies by payer and location. Consult your specific payer's fee schedule for current RVU values.
- Global Days: This is a diagnostic procedure; therefore, a global period does not apply.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier is not applicable to this diagnostic arthroscopy code.
- Fee Schedule: Fee schedule data is not available in the provided sources.Consult a fee schedule database for historical and current payment information. These values vary considerably with location and payer.
- Specialties:Orthopedic Surgery, Sports Medicine
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Outpatient)