2025 CPT code 29868
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Arthroscopy Musculoskeletal System Feed
Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral.
Modifiers 51 (multiple procedures), 76 (repeat procedure), and 80 (assistant surgeon) may be applicable depending on the circumstances of the procedure.Always refer to the appropriate payer's guidelines for modifier use.
Medical necessity is established through documentation of significant meniscal damage, causing symptoms such as pain, instability, and limitations in mobility.Conservative treatments such as physical therapy must be documented as having failed to alleviate symptoms.The size and quality of the allograft must be documented.
The physician or qualified healthcare professional performs the arthroscopic procedure, including the diagnostic portion, the arthrotomy (if needed), the insertion of the meniscal allograft, and closure of the incisions.Pre-operative and post-operative care are separately billable.
In simple words: The doctor uses a small camera (arthroscope) to look inside the knee joint and repair a damaged meniscus, a piece of cartilage that acts like a cushion. They make a small cut to insert a new meniscus taken from a donor.
This CPT code encompasses surgical arthroscopy of the knee joint, specifically involving meniscal transplantation.The procedure includes an arthrotomy (surgical incision of the joint) to facilitate the insertion of a meniscal allograft (tissue graft from a donor).The transplantation can be performed on either the medial or lateral meniscus.The code inherently includes the diagnostic arthroscopy portion of the procedure.
Example 1: A 35-year-old athlete sustains a severe meniscus tear during a sporting event.Arthroscopic examination reveals extensive damage to the medial meniscus, requiring complete removal.A meniscal allograft is transplanted using this code. , A 50-year-old patient presents with chronic knee pain and limited mobility.MRI reveals a degenerative tear of the lateral meniscus.Arthroscopy with meniscal transplantation is performed using code 29868., A 28-year-old patient undergoes a total knee replacement. During the procedure, a portion of the meniscus is damaged. A meniscal allograft is transplanted during the same surgical session.
Detailed medical history, physical examination findings, imaging studies (MRI, X-rays) demonstrating the extent of meniscal damage, operative report detailing the procedure performed (including size and source of allograft), and post-operative progress notes.Documentation must also support medical necessity.
** Accurate coding requires careful documentation of the procedure performed, including the size and source of the allograft, and the location of the meniscus (medial or lateral).Always check with the payer for specific reimbursement policies and NCCI edits.
- Revenue Code: P1A (Major Procedure - Breast) - Note: This revenue code may not be entirely accurate and requires further verification based on the specific payer and circumstances.
- RVU: This information is not available in the provided text.Relative Value Units (RVUs) vary by payer and location. Consult the specific payer's fee schedule for the most accurate information.
- Global Days : The global period for this procedure is not specified in the provided text.The global period will vary depending on the payer and specific circumstances.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule : Fee schedule data is not available in this source. This information is specific to payers and may be found in payer-specific fee schedules.
- Specialties:Orthopedic Surgery
- Place of Service:Ambulatory Surgical Center, Inpatient Hospital, Outpatient Hospital