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The procedure described by CPT® Code 29835 refers to a surgical arthroscopy of the elbow specifically for a partial synovectomy. This minimally invasive technique involves the removal of the synovial tissue from one compartment of the elbow joint. The procedure is typically indicated for patients experiencing symptoms related to synovial inflammation or other conditions affecting the elbow joint. During the surgery, the patient is positioned in a lateral decubitus position, which allows for optimal access to the elbow while ensuring the forearm can move freely. The surgeon makes incisions at midlateral and posterior portals to access the joint. The posterior compartment is examined first, and if necessary, the synovium surrounding the olecranon fossa is excised using an arthroscopic shaver. The medial gutter is then addressed, where small rongeurs are utilized to clear any obstructive tissue. Care is taken to protect the ulnar nerve during this process. Following the posterior compartment work, anterior portal incisions are created to explore the anterior compartment, where additional synovectomy is performed. The procedure concludes with the flushing of the compartments with saline solution and closure of the incisions. This code is specifically used for cases where only one compartment is treated, distinguishing it from CPT® Code 29836, which is used for complete synovectomy involving both compartments of the elbow.
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The procedure described by CPT® Code 29835 is indicated for various conditions affecting the elbow joint, particularly those involving synovial inflammation or pathology. The following are specific indications for performing a partial synovectomy:
The procedure for CPT® Code 29835 involves several key steps to ensure effective synovectomy of the elbow joint. The following outlines the procedural steps in detail:
After the completion of the partial synovectomy, the patient may require specific post-procedure care to ensure proper recovery. This typically includes monitoring for any signs of infection at the incision sites, managing pain with prescribed medications, and following a rehabilitation protocol to restore elbow function. Patients are often advised to avoid strenuous activities and heavy lifting for a specified period to allow for healing. Follow-up appointments may be scheduled to assess the recovery progress and to determine when physical therapy can begin to enhance mobility and strength in the elbow joint.
| Short Descr | ELBOW ARTHROSCOPY/SURGERY | Medium Descr | ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY PARTIAL | Long Descr | Arthroscopy, elbow, surgical; synovectomy, partial | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 3 - Special payment adjustment rules for multiple endoscopic procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Endoscopic Base Code | 29830 Arthroscopy, elbow, diagnostic, with or without synovial biopsy (separate 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 | 162 - Other OR therapeutic procedures on joints |
| 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 | FA | Left hand, thumb | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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) | SG | Ambulatory surgical center (asc) facility service | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 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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