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The procedure described by CPT® Code 29836 refers to a surgical arthroscopy of the elbow that involves a complete synovectomy. In this context, 'arthroscopy' is a minimally invasive surgical technique that allows for the examination and treatment of joint conditions through small incisions. The term 'synovectomy' specifically denotes the surgical removal of the synovial membrane, which is the tissue lining the joint that can become inflamed or thickened due to various conditions, such as arthritis or other inflammatory diseases. This procedure is typically indicated when there is significant synovial pathology affecting the elbow joint, leading to pain, swelling, and reduced range of motion. The complete synovectomy entails addressing both the posterior and anterior compartments of the elbow, ensuring thorough removal of the diseased synovial tissue to alleviate symptoms and improve joint function. The patient is positioned in a way that facilitates access to the elbow joint, and the procedure is performed using specialized instruments designed for arthroscopic surgery, which minimizes trauma to surrounding tissues and promotes quicker recovery compared to open surgical techniques.
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The procedure is indicated for patients experiencing significant synovial pathology in the elbow joint, which may include the following conditions:
The surgical procedure for CPT® Code 29836 involves several key steps to ensure a complete synovectomy of the elbow joint:
After the completion of the synovectomy, post-procedure care typically involves monitoring the patient for any immediate complications. Patients may be advised to rest the elbow and may require a period of immobilization to promote healing. Pain management strategies will be discussed, and physical therapy may be recommended to restore range of motion and strength in the elbow joint. Follow-up appointments will be necessary to assess recovery and ensure that the joint is healing properly.
| Short Descr | ELBOW ARTHROSCOPY/SURGERY | Medium Descr | ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY COMPLETE | Long Descr | Arthroscopy, elbow, surgical; synovectomy, complete | 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). | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 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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