2025 CPT code 29870
(Active) Effective Date: N/A Revision Date: N/A Surgery - Arthroscopy Musculoskeletal System Feed
Diagnostic arthroscopy of the knee, with or without synovial biopsy.
Modifiers 59 (distinct procedural service), RT (right side), and LT (left side) may be applicable, depending on the circumstances of the procedure.
Medical necessity is established when there is a clinical indication for a diagnostic arthroscopy of the knee based on symptoms, physical examination findings, and/or imaging studies suggestive of intra-articular pathology.The diagnostic arthroscopy is needed to confirm or rule out a specific diagnosis and to guide subsequent management.
The physician or qualified healthcare professional performs the arthroscopic examination of the knee joint. This includes prepping the patient, making small incisions, inserting the arthroscope, infusing saline solution, visualizing the joint structures, obtaining a synovial biopsy if needed, irrigating the joint, hemostasis (control of bleeding), removing instruments and closing the incisions.
In simple words: The doctor uses a small camera (arthroscope) to look inside the knee joint to see what's causing pain or stiffness.Sometimes, a small tissue sample (biopsy) might be taken for testing.
This CPT code encompasses a diagnostic arthroscopic examination of the knee joint.The procedure involves the insertion of an arthroscope to visually assess the internal structures of the knee, including the menisci, ligaments, articular cartilage, and synovium. A synovial biopsy may be performed if clinically indicated.The procedure is strictly diagnostic and does not include any surgical repair or intervention.Any surgical procedures performed during the same session should be reported separately, using appropriate CPT codes and modifiers.
Example 1: A patient presents with chronic knee pain and swelling. A diagnostic arthroscopy is performed to evaluate for meniscal tears, ligamentous injuries, or other intra-articular pathology. No surgical repair is needed., A patient experiences acute knee pain after a twisting injury. A diagnostic arthroscopy reveals a small loose body in the joint.The surgeon decides to remove the loose body, which is then coded separately., A patient with persistent knee inflammation undergoes a diagnostic arthroscopy.A synovial biopsy is taken to determine the cause of the inflammation. The biopsy is sent to pathology for analysis; additional codes for the biopsy are required.
Complete medical history, physical examination findings, imaging studies (X-rays, MRI), operative report detailing the findings of the arthroscopy, pathology report (if biopsy performed).
** This code is used for diagnostic purposes only. Any surgical intervention performed during the same session should be reported with separate CPT codes.The use of modifier 59 should be carefully considered and justified based on the circumstances.
- Payment Status: Active
- Modifier TC rule: Not applicable; this is a diagnostic procedure.
- Specialties:Orthopedic Surgery, Sports Medicine
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center