Summary & Overview
CPT 29846: Arthroscopic TFCC Repair or Debridement, Wrist
CPT code 29846 covers arthroscopic evaluation and repair or debridement of the triangular fibrocartilage complex (TFCC) in the wrist. This procedure is clinically important because TFCC injuries are a common source of ulnar-sided wrist pain and dysfunction; arthroscopic intervention can be diagnostic and therapeutic while minimizing soft-tissue disruption. Nationally, utilization and reimbursement for wrist arthroscopy affect outpatient surgical volumes, ambulatory surgery center planning, and specialty practice economics.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical description, typical settings of care, and the payer mix considered. The publication outlines expected billing context, common modifiers (input provided), and a national lens on where this procedure fits within hand and wrist surgical care pathways. It also highlights benchmarks and policy elements relevant to payer coverage and site-of-service considerations where available. Data not available in the input is noted explicitly in relevant sections.
Billing Code Overview
CPT code 29846 describes an arthroscopic evaluation and surgical repair or debridement of the triangular fibrocartilage complex (TFCC) inside the wrist joint. The provider inspects intra-articular wrist structures with an arthroscope, inserts instruments to repair or excise the TFCC, and removes a minimal amount of additional damaged tissue as needed.
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Service type: Arthroscopic wrist surgery (TFCC repair/debridement)
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Typical site of service: Ambulatory surgery center or hospital operating room
Clinical & Coding Specifications
Clinical Context
A 38-year-old right-hand–dominant female presents with chronic ulnar-sided wrist pain after a fall on an outstretched hand three months prior. She reports persistent deep aching at the distal radioulnar joint and worsened pain with forearm rotation and load-bearing activities. Physical exam reveals tenderness at the ulnar wrist and a positive ulnar fovea sign. Wrist radiographs show no acute fracture; MRI demonstrates a degenerated and torn triangular fibrocartilage complex (TFCC) with a small adjacent synovitis. After failed conservative care including immobilization, nonsteroidal anti-inflammatory drugs, and cortisone injection, the orthopaedic hand surgeon schedules arthroscopic repair/excision of TFCC.
The clinical workflow includes preoperative evaluation and informed consent, operating room arthroscopy under regional or general anesthesia, diagnostic arthroscopy of the radiocarpal and distal radioulnar joints with probe assessment of the TFCC, arthroscopic repair or debridement of the torn triangular fibrocartilage, minimal excision of additional damaged intra-articular tissue as needed, wound closure, and postoperative hand therapy with activity restrictions. Typical intraoperative documentation includes CPT code 29846, laterality, anesthesia record, operative findings, specific repair or debridement maneuvers, estimated blood loss, and postoperative plan.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
RT |