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The procedure described by CPT® Code 29837 refers to a surgical arthroscopy of the elbow that involves limited debridement. In this context, "arthroscopy" is a minimally invasive surgical technique that allows a physician to visualize, diagnose, and treat conditions within a joint using a small camera called an arthroscope. The elbow joint is accessed through small incisions, which minimizes tissue damage and promotes quicker recovery compared to open surgery. The term "debridement" refers to the surgical removal of damaged tissue or foreign objects from a wound or joint. In this procedure, the surgeon focuses on cleaning out the elbow joint by removing osteophytes, commonly known as bone spurs, and smoothing the articular cartilage to improve joint function and alleviate pain. The patient is positioned in a lateral decubitus position, which facilitates access to the elbow while allowing the forearm to move freely. This procedure is particularly beneficial for patients experiencing pain or limited range of motion due to degenerative changes or other conditions affecting the elbow joint.
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The procedure described by CPT® Code 29837 is indicated for patients experiencing specific symptoms or conditions related to the elbow joint. These indications may include:
The procedure begins with the patient positioned in a lateral decubitus position, which allows the upper arm to be supported while the forearm hangs freely. This positioning is crucial for optimal access to the elbow joint. The surgeon then makes midlateral and posterior portal incisions to access the joint. The posterior compartment of the elbow is explored first, where the surgeon assesses the condition of the joint. If debridement is necessary in this compartment, the surgeon removes osteophytes and smooths the articular cartilage using specialized instruments such as arthroscopic shavers and rongeurs. After completing the debridement in the posterior compartment, the area is irrigated with saline solution to clear debris and ensure a clean surgical field.
Following the posterior compartment work, anterior portal incisions are created to access the anterior compartment of the elbow. A retractor is placed in the proximal anterolateral portal to enhance visualization. The arthroscope and surgical instruments are then inserted through the anterolateral and proximal anteromedial portals to explore the anterior compartment. Similar to the posterior compartment, debridement is performed as needed to remove any damaged tissue or bone spurs. Once the debridement is complete, the anterior compartment is also flushed with saline solution to ensure cleanliness. Finally, the arthroscope and instruments are removed, and the portal incisions are closed to complete the procedure.
After the completion of the arthroscopy and debridement, patients are typically monitored for a short period to ensure there are no immediate complications. Post-procedure care may include recommendations for rest, ice application to reduce swelling, and pain management strategies. Patients are often advised to follow a rehabilitation program that includes physical therapy to restore range of motion and strength in the elbow. The expected recovery time can vary based on the extent of the debridement and the individual patient's healing process. Follow-up appointments are usually scheduled to assess the healing progress and determine when the patient can safely resume normal activities.
| Short Descr | ELBOW ARTHROSCOPY/SURGERY | Medium Descr | ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT LIMITED | Long Descr | Arthroscopy, elbow, surgical; debridement, limited | 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. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 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). | 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 | 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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