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CPT®
29887

CPT® Code 29887

Official Description

Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion with internal fixation

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Arthroscopy of the knee is a minimally invasive surgical procedure that allows for the examination and treatment of various knee joint conditions. Specifically, CPT® Code 29887 refers to the surgical arthroscopy performed to address an intact osteochondritis dissecans lesion through a technique known as drilling, accompanied by internal fixation. Osteochondritis dissecans is a pathological condition characterized by the separation of a fragment of bone and the overlying cartilage from the underlying bone, typically occurring in the knee joint. This condition can lead to the formation of loose bodies within the joint, which may cause pain, swelling, and restricted movement. The procedure involves making small incisions, or portals, on the medial and lateral sides of the knee to introduce an arthroscope, a specialized instrument equipped with a camera that provides a visual assessment of the joint. The surgeon can then flush the joint with saline to clear debris and examine the area for any signs of disease, injury, or infection. The drilling technique is employed to create small tunnels through the articular cartilage and into the underlying bone, facilitating the infiltration of blood vessels that promote healing and the replacement of necrotic bone with viable tissue. In cases where the osteochondritis dissecans lesion is extensive or chronic, bone grafts may be utilized to fill the drilled holes, enhancing the stability and healing of the affected area. Internal fixation may also be applied to secure the dissecans fragment, ensuring proper alignment and stabilization during the recovery process.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 29887 is indicated for the treatment of an intact osteochondritis dissecans lesion in the knee. This condition may present with various symptoms and complications, necessitating surgical intervention. The following are the explicit indications for performing this procedure:

  • Intact Osteochondritis Dissecans Lesion - The primary indication for this procedure is the presence of an intact osteochondritis dissecans lesion, which may cause joint pain, swelling, and mechanical symptoms such as locking or catching in the knee.
  • Presence of Loose Bodies - If the osteochondritis dissecans lesion has resulted in the formation of loose bodies within the knee joint, surgical intervention may be required to remove these fragments and restore normal joint function.
  • Chronic Symptoms - Patients experiencing chronic knee pain or dysfunction due to osteochondritis dissecans that has not responded to conservative treatment options may be candidates for this surgical procedure.

2. Procedure

The procedure for CPT® Code 29887 involves several critical steps to effectively treat the intact osteochondritis dissecans lesion. The following outlines the procedural steps:

  • Step 1: Portal Incision - The surgeon begins by making small incisions, known as portals, on the medial and lateral aspects of the knee joint. These incisions provide access for the arthroscope and other surgical instruments.
  • Step 2: Introduction of Arthroscope - An arthroscope is introduced through one of the portals, allowing the surgeon to visualize the internal structures of the knee joint. This visualization is crucial for assessing the condition of the joint and the osteochondritis dissecans lesion.
  • Step 3: Joint Flushing - A cannula is inserted through a second portal, and the joint is flushed with saline solution. This step helps to clear any debris and provides a clearer view of the joint's interior.
  • Step 4: Examination of the Joint - The surgeon examines the knee joint for any signs of disease, injury, or infection, focusing on the dissecans fragment to determine the appropriate course of action.
  • Step 5: Debridement of the Lesion - The base of the osteochondritis dissecans lesion is debrided as necessary to prepare it for the drilling procedure.
  • Step 6: Drilling - Multiple small drill holes are created through the articular cartilage, extending into the underlying diseased or necrotic bone. This drilling creates tunnels that facilitate the infiltration of blood vessels, promoting healing and the replacement of dead bone with living tissue.
  • Step 7: Bone Grafting (if necessary) - In cases where the lesion is large or chronic, bone grafts may be harvested from the proximal tibia and packed into the drilled holes to enhance stability and healing.
  • Step 8: Internal Fixation - Internal fixation may be applied, either alone or in conjunction with bone grafting, to compress and stabilize the dissecans fragment, ensuring proper alignment during the healing process.
  • Step 9: Final Flushing and Inspection - After completing the necessary interventions, the knee is flushed again with saline solution to remove any remaining debris, and the joint is re-inspected to confirm the success of the procedure.
  • Step 10: Closure of Incisions - Finally, the arthroscope, cannula, and other instruments are removed, and the portal incisions are closed to complete the procedure.

3. Post-Procedure

Post-procedure care following the arthroscopy for an intact osteochondritis dissecans lesion is essential for optimal recovery. Patients may be advised to rest and limit weight-bearing activities on the affected knee for a specified period to allow for healing. Pain management strategies, including the use of analgesics, may be implemented to alleviate discomfort following the surgery. Physical therapy may be recommended to restore range of motion, strength, and function to the knee joint. The healthcare provider will monitor the surgical site for any signs of infection or complications and provide guidance on rehabilitation exercises to facilitate recovery. Follow-up appointments will be scheduled to assess the healing process and determine when the patient can safely resume normal activities.
Short Descr KNEE ARTHROSCOPY/SURGERY
Medium Descr ARTHRS KNEE DRLG OSTEOCHOND DISSECANS INT FIXJ
Long Descr Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion with internal fixation
Status Code Active Code
Global Days 090 - Major Surgery
Preoperative
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 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 162 - Other OR therapeutic procedures on joints
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).
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.
Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
This service has been performed in part by a resident under the direction of a teaching physician
Left side (used to identify procedures performed on the left side of the body)
Right side (used to identify procedures performed on the right side of the body)
Ambulatory surgical center (asc) facility service
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Pre-1990 Added Code added.
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