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The CPT® Code 29856 refers to the arthroscopically aided treatment of a proximal tibial plateau fracture, specifically a bicondylar fracture. This type of fracture occurs at the upper end of the tibia, which is the larger bone in the lower leg, and involves both the medial and lateral condyles. The proximal tibial plateau is crucial as it forms the lower surface of the knee joint and is integral to weight-bearing and joint stability. The procedure utilizes an arthroscope, a specialized instrument that allows for visualization inside the joint, enabling the surgeon to assess the extent of the injury accurately. The treatment may involve internal fixation, which is the surgical stabilization of the fracture using devices such as screws or plates. The approach is minimally invasive, as it includes making small portal incisions over the knee joint to insert instruments and visualize the fracture site. This method allows for a thorough examination and treatment of the fracture while minimizing damage to surrounding tissues. The specific techniques employed during the procedure can vary based on the fracture's configuration, ensuring that the treatment is tailored to the individual patient's needs.
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The procedure described by CPT® Code 29856 is indicated for the treatment of specific types of tibial fractures. The following conditions warrant this surgical intervention:
The procedure for CPT® Code 29856 involves several key steps to ensure effective treatment of the bicondylar proximal tibial plateau fracture:
Post-procedure care following the arthroscopically aided treatment of a bicondylar proximal tibial plateau fracture includes monitoring for complications, managing pain, and initiating rehabilitation. Patients are typically advised to follow up with their healthcare provider to assess healing and function. Rehabilitation may involve physical therapy to restore range of motion and strength in the knee joint. The recovery process can vary based on the individual patient's condition and the complexity of the fracture, but adherence to post-operative instructions is essential for optimal recovery.
| Short Descr | TIBIAL ARTHROSCOPY/SURGERY | Medium Descr | ARTHRS AID TIBIAL FX PROX UNICONDYLAR BICONDYLAR | Long Descr | Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy) | 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) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met. | 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 | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P8A - Endoscopy - arthroscopy | MUE | 1 | CCS Clinical Classification | 147 - Treatment, fracture or dislocation of lower extremity (other than hip or femur) |
| 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. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, 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) | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period |
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| 2008-01-01 | Changed | Code description changed. |
| 1993-01-01 | Added | First appearance in code book in 1993. |
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