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The procedure described by CPT® Code 29830 refers to a diagnostic arthroscopy of the elbow, which may include a synovial biopsy as a separate procedure. This minimally invasive surgical technique allows for direct visualization of the elbow joint through small incisions, facilitating the assessment of joint conditions. During the procedure, the patient is positioned in a lateral decubitus position, which means they lie on their side, with the upper arm supported to enable the forearm to move freely. This positioning is crucial for optimal access to the elbow joint. The surgeon makes midlateral and posterior portal incisions to access the joint. Initially, the posterior compartment of the elbow is explored, and if necessary, synovial tissue samples are collected for further analysis. Following this, anterior portal incisions are created to allow access to the anterior compartment. A retractor is utilized to enhance visibility during this phase. The arthroscope and surgical instruments are introduced through the anterolateral and proximal anteromedial portals, enabling thorough exploration and potential biopsy of the anterior compartment. After the necessary evaluations and tissue sampling, the elbow joint is irrigated with saline solution to ensure cleanliness, and the instruments are withdrawn. Finally, the portal incisions are closed, completing the procedure. This diagnostic approach is essential for identifying various elbow pathologies, including inflammatory conditions, degenerative changes, and other joint disorders.
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The diagnostic arthroscopy of the elbow, as described by CPT® Code 29830, is indicated for various conditions that may affect the elbow joint. The following are explicitly provided indications for this procedure:
The procedure for CPT® Code 29830 involves several key steps that are performed in a systematic manner to ensure thorough evaluation of the elbow joint. The following procedural steps are outlined:
After the completion of the diagnostic arthroscopy, the patient may require specific post-procedure care to ensure proper recovery. It is important to monitor the surgical site for any signs of infection or complications. Patients are typically advised to rest the elbow and may be instructed to apply ice to reduce swelling. Pain management may be necessary, and the physician may prescribe analgesics as needed. Follow-up appointments are essential to assess the healing process and to discuss the results of any biopsies taken during the procedure. Rehabilitation exercises may be recommended to restore range of motion and strength in the elbow joint as healing progresses.
| Short Descr | ELBOW ARTHROSCOPY | Medium Descr | ARTHROSCOPY ELBOW DIAG W/WO SYNOVIAL BIOPSY SPX | Long Descr | Arthroscopy, elbow, diagnostic, with or without synovial biopsy (separate procedure) | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P8A - Endoscopy - arthroscopy | MUE | 1 | CCS Clinical Classification | 149 - Arthroscopy |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| Pre-1990 | Added | Code added. |
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