Billing and Coding: Arthroscopic Lavage and Arthroscopic Debridement for the Osteoarthritic Knee – Medical Policy Article

CMS considers arthroscopic lavage alone, arthroscopic debridement for osteoarthritic patients with pain only, and arthroscopic debridement/lavage for patients with severe knee osteoarthritis to be non-covered. Arthroscopic procedures for patients without severe osteoarthritis who have mechanical symptoms, abnormal limb/knee alignment, or early/less severe degenerative arthritis are adjudicated at local Medicare contractor discretion; contractors may require operative notes, standing x-rays, or arthroscopy results and specific coding/billing (eg, CPT 29999, 29877, HCPCS G0289). Claims must include a valid ICD-10-CM diagnosis code, applicable referring physician NPI when required, and providers should check NCCI/OPPS edits and consider issuing an ABN for services likely to be non-covered.

"Arthroscopic lavage or arthroscopic debridement for osteoarthritic knee in patients WITHOUT severe osteoarthritis who present with mechanical symptoms (eg, locking, snapping, popping), abnormal lim..."