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The procedure described by CPT® Code 29905 refers to an arthroscopic surgical intervention performed on the subtalar joint, which is located in the lower ankle between the talus and the calcaneus bones. This joint is classified as a compound joint, meaning it consists of multiple components and is divided into two distinct compartments. The separation of these compartments is facilitated by the presence of the talocalcaneal and cervical ligaments. During the procedure, the surgeon first distracts the joint to create space between the joint surfaces, which enhances visibility and access to the entire joint structure. Following this, two or three access portals are established to allow for thorough examination of the joint. The primary focus of the surgery is to identify and remove any diseased or hypertrophic synovium, which is the connective tissue lining the joint. A specialized instrument known as a shaver is utilized to excise the abnormal synovium effectively. After the synovectomy, the joint is irrigated to clear out any debris, ensuring a clean surgical site. To promote optimal healing post-surgery, the foot is positioned in a neutral plantigrade stance, with the heel angled between five to ten degrees of valgus. Finally, a brace or splint is applied to stabilize the joint during the recovery process.
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The procedure is indicated for patients experiencing conditions related to the subtalar joint that may necessitate surgical intervention. These indications may include:
The surgical procedure for CPT® Code 29905 involves several key steps to ensure effective treatment of the subtalar joint. The process begins with the patient being positioned appropriately to allow access to the ankle. Following this, the surgeon administers anesthesia to ensure the patient is comfortable throughout the procedure. The first step involves distracting the subtalar joint, which is crucial for separating the joint surfaces and enhancing visibility. This distraction allows the surgeon to examine the joint thoroughly.
Post-procedure care following an arthroscopy of the subtalar joint with synovectomy is essential for recovery. Patients are typically advised to keep the foot elevated to reduce swelling and to follow specific weight-bearing restrictions as directed by the surgeon. The application of a brace or splint is crucial to maintain joint stability during the healing phase. Patients may also be instructed to engage in physical therapy to restore range of motion and strength in the joint gradually. Regular follow-up appointments are necessary to monitor the healing process and address any complications that may arise.
| Short Descr | SUBTALAR ARTHRO W/EXC | Medium Descr | ARTHROSCOPY SUBTALAR JOINT WITH SYNOVECTOMY | Long Descr | Arthroscopy, subtalar joint, surgical; with synovectomy | 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) | 0 - Co-surgeons not permitted for this procedure. | 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 | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 162 - Other OR therapeutic procedures on joints |
| LT | Left side (used to identify procedures performed on the left side of the body) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 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). | 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. | 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.) | 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). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | RT | Right side (used to identify procedures performed on the right side of the body) | 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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| 2008-01-01 | Added | First appearance in code book in 2008. |
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