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Official Description

Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

A surgical arthroscopy of the knee, as described by CPT® Code 29884, involves a minimally invasive procedure where a small camera, known as an arthroscope, is inserted into the knee joint through small incisions, referred to as portals. This procedure specifically focuses on the lysis of adhesions, which are bands of scar tissue that can form in the knee joint, often as a complication from previous surgeries such as anterior cruciate ligament (ACL) repair or total knee arthroplasty. Adhesions can also develop following intra-articular fractures, leading to restricted movement and discomfort. During the procedure, the surgeon makes medial and lateral incisions to access the knee joint, allowing for a thorough examination of the joint's internal structures. The introduction of a cannula through one of the portals enables the joint to be flushed with saline solution, which helps in visualizing the area and clearing any debris. The surgeon then carefully cuts the adhesions and removes any fibrous bands or scar tissue that may be limiting the knee's range of motion. After the adhesions are addressed, the knee is flushed again to ensure cleanliness, and the joint is re-examined for any remaining issues. The procedure concludes with the removal of the arthroscope and cannula, followed by the closure of the incisions. To enhance postoperative recovery, the knee is manually flexed and extended while the patient remains under anesthesia, promoting optimal range of motion.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 29884 is indicated for patients experiencing complications due to adhesions in the knee joint. These adhesions may arise from various conditions, including:

  • Prior Knee Surgery: Adhesions can develop as a result of previous surgical interventions, such as anterior cruciate ligament (ACL) repair or total knee arthroplasty, leading to restricted movement and discomfort.
  • Intra-Articular Fractures: Following an intra-articular fracture, scar tissue may form within the knee joint, necessitating surgical intervention to restore normal function.

2. Procedure

The procedure for CPT® Code 29884 involves several key steps that are performed to effectively address the adhesions within the knee joint. These steps include:

  • Step 1: Portal Incision Creation The surgeon begins by making small incisions on the medial and lateral sides of the knee joint. These incisions serve as access points for the arthroscope and other surgical instruments.
  • Step 2: Arthroscope Introduction An arthroscope, which is a specialized camera, is inserted through one of the portals. This device allows the surgeon to visualize the internal structures of the knee joint on a monitor, facilitating a detailed examination.
  • Step 3: Cannula Insertion and Joint Flushing A cannula is then introduced through a second portal. Saline solution is flushed into the joint through this cannula, which helps to clear debris and improve visibility of the joint's interior.
  • Step 4: Examination of the Knee The surgeon conducts a thorough examination of the knee joint to identify any signs of disease, injury, or infection that may be present, in addition to the adhesions.
  • Step 5: Lysis of Adhesions Once the adhesions are identified, the surgeon carefully cuts and removes the fibrous bands or scar tissue that are causing restrictions in movement. This step is crucial for restoring normal function to the knee.
  • Step 6: Final Flushing and Inspection After the adhesions have been addressed, the knee is flushed again with saline solution to remove any remaining debris. The joint is then re-inspected to ensure that all issues have been resolved.
  • Step 7: Removal of Instruments and Closure Upon completion of the procedure, the arthroscope, cannula, and any other instruments used are removed. The portal incisions are then closed to complete the surgical process.
  • Step 8: Manual Manipulation of the Knee To promote optimal recovery and range of motion, the knee is manually extended and flexed while the patient is still under anesthesia, ensuring that the joint can move freely post-procedure.

3. Post-Procedure

After the completion of the arthroscopy and lysis of adhesions, patients can expect a recovery period that may involve monitoring for any signs of complications. Post-procedure care typically includes instructions for pain management, activity restrictions, and rehabilitation exercises to enhance recovery. Patients are advised to follow up with their healthcare provider to assess the healing process and to ensure that the knee regains its full range of motion. Physical therapy may be recommended to aid in the rehabilitation process and to strengthen the knee joint.

Short Descr KNEE ARTHROSCOPY/SURGERY
Medium Descr ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX
Long Descr Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
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 29870  Arthroscopy, knee, 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 150 - Division of joint capsule, ligament or cartilage

This is a primary code that can be used with these additional add-on codes.

G0289 Add-on Code Medicare Coverage: Carrier Priced MPFS Status: Active Code APC N Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee
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)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
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).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
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.
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.)
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).
GC This service has been performed in part by a resident under the direction of a teaching physician
SG Ambulatory surgical center (asc) facility service
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
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
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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