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Official Description

Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 29888 involves an arthroscopically aided repair, augmentation, or reconstruction of the anterior cruciate ligament (ACL) in the knee. The ACL is a critical ligament located in the center of the knee joint, connecting the femur (thigh bone) to the tibia (shin bone). It plays a vital role in providing stability and controlling rotational movements of the knee. Injury to the ACL can lead to significant instability, causing the knee to buckle during activities. This procedure is performed using an arthroscope, a specialized instrument that allows the physician to visualize the inside of the knee joint through small incisions, known as portals. Typically, three or more portal incisions are made to facilitate the introduction of the arthroscope and surgical tools. The knee joint is flushed with saline to clear any debris, and the physician examines the meniscal cartilage and the condition of the ACL. If a tear is identified, the damaged ACL is either repaired or reconstructed. The procedure may involve harvesting a graft from the patellar tendon, which is then used to replace the torn ACL. The surgical steps include creating drill holes in the tibia and femur to secure the graft, ensuring proper alignment and stability of the knee joint post-surgery. This minimally invasive approach aims to restore function and stability to the knee while promoting a quicker recovery compared to traditional open surgery.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 29888 is indicated for patients who have sustained a tear or injury to the anterior cruciate ligament (ACL). The following conditions may warrant this surgical intervention:

  • ACL Tear A complete or partial tear of the ACL, often resulting from sports-related injuries or trauma.
  • Knee Instability Patients experiencing significant instability in the knee joint, which may lead to buckling or difficulty in performing daily activities.
  • Meniscal Injury Concurrent meniscal tears that may require evaluation and treatment during the ACL reconstruction procedure.

2. Procedure

The procedure for arthroscopically aided anterior cruciate ligament repair or reconstruction involves several detailed steps:

  • Portal Incision Creation The surgeon makes three or more small incisions around the knee joint to create portals for the arthroscope and surgical instruments. This minimally invasive approach allows for better visualization and access to the joint.
  • Joint Examination An arthroscope is inserted through one of the incisions, and an irrigation cannula is introduced through another. The knee is flushed with saline solution to clear any cloudy fluid or debris. The physician uses a video camera attached to the arthroscope to examine the knee joint, including the meniscal cartilage and the condition of the ACL.
  • ACL Assessment and Preparation If a torn ACL is identified, the surgeon uses a shaver to remove the damaged tissue. The notch where the ACL is located is inspected and may be widened using a burr to facilitate the reconstruction.
  • Graft Harvesting If the patellar tendon is selected for reconstruction, two small incisions are made—one over the tibial tubercle and another over the inferior aspect of the patella. The central third of the patellar tendon is harvested, including a bone block at each end.
  • Drilling and Graft Placement The harvested patellar tendon graft is passed beneath the skin and retrieved. Sutures are placed through the bone blocks. Using arthroscopic assistance, a drill guide is positioned on the tibia, and a guide wire is drilled into place, exiting within the knee joint at the original ACL attachment site. A drill hole is then made in the tibia. A femoral drill guide is passed through the tibial drill hole, positioned on the posterior aspect of the femur, and a femoral drill hole is created.
  • Securing the Graft The drill holes are inspected using the arthroscope, and the patellar tendon or other graft material is placed through the drill holes. The graft is secured with screws to ensure stability.
  • Closure After confirming the proper placement and integrity of the ACL graft, the arthroscope and surgical instruments are removed, and the incisions are closed.

3. Post-Procedure

Post-procedure care following an arthroscopically aided ACL repair or reconstruction typically includes monitoring for any complications, managing pain, and initiating rehabilitation. Patients are often advised to follow a structured physical therapy program to regain strength and mobility in the knee. Recovery time may vary based on the extent of the injury and the surgical technique used, but patients can generally expect a gradual return to normal activities over several months. Follow-up appointments are essential to assess healing and ensure proper recovery.

Short Descr KNEE ARTHROSCOPY/SURGERY
Medium Descr ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ
Long Descr Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
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) 1 - Co-surgeons could be paid, though supporting documentation is required...
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 149 - Arthroscopy

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)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
RT Right side (used to identify procedures performed on the right side of the body)
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.
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).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient 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).
81 Minimum assistant surgeon: minimum surgical assistant services are identified by adding modifier 81 to the usual procedure number.
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).
CR Catastrophe/disaster related
GC This service has been performed in part by a resident under the direction of a teaching physician
PO Excepted service provided at an off-campus, outpatient, provider-based department of a hospital
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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