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Surgical arthroscopy of the wrist is a minimally invasive procedure that involves the examination and treatment of the wrist joint through small incisions. Specifically, CPT® Code 29844 refers to a partial synovectomy, which is the surgical removal of a portion of the synovial membrane that lines the joint. This procedure is typically indicated for patients suffering from inflammation of the synovial tissue, often due to conditions such as rheumatoid arthritis. The synovial membrane can become thickened and inflamed, leading to pain and restricted movement in the wrist. By performing a partial synovectomy, the surgeon aims to alleviate symptoms, improve joint function, and enhance the overall quality of life for the patient. The procedure is performed under sterile conditions, utilizing specialized instruments and techniques to ensure precision and minimize recovery time. The use of a pneumatic tourniquet and wrist traction device during the procedure aids in better visualization and access to the joint structures, allowing for effective removal of the inflamed tissue while preserving healthy joint components.
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Arthroscopy of the wrist with partial synovectomy is indicated for the following conditions:
The procedure for a partial synovectomy via wrist arthroscopy involves several key steps:
After the partial synovectomy, patients can expect a recovery period that may involve rest and immobilization of the wrist to promote healing. Pain management strategies will be discussed, and physical therapy may be recommended to restore mobility and strength in the wrist. Follow-up appointments will be necessary to monitor the healing process and assess the effectiveness of the procedure. Patients should be advised on signs of complications, such as increased swelling, redness, or fever, which should prompt immediate medical attention.
| Short Descr | WRIST ARTHROSCOPY/SURGERY | Medium Descr | ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY PARTIAL | Long Descr | Arthroscopy, wrist, 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) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Endoscopic Base Code | 29840 Arthroscopy, wrist, 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. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 81 | Minimum assistant surgeon: minimum surgical assistant services are identified by adding modifier 81 to the usual procedure number. | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | F1 | Left hand, second digit | 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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