Summary & Overview
CPT 29874: Arthroscopic Removal of Loose or Foreign Body, Knee
CPT code 29874 denotes arthroscopic removal of loose or foreign bodies from the knee joint. The procedure addresses intra-articular fragments such as cartilage pieces that contribute to pain, inflammation, scar tissue, adhesions, and reduced mobility. As a commonly billed arthroscopic knee intervention, 29874 is clinically important for restoring joint function and reducing symptomatic burden for patients with mechanical intra-articular debris.
Key national payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and typical settings for the procedure, followed by benchmarking information and payer coverage considerations where available. The publication highlights payment benchmarks, utilization patterns, and relevant coding notes for billing professionals and policy analysts.
The report is organized to deliver practical information quickly: a clinical description and site-of-service framing, payer coverage scope, common modifiers and billing considerations, and implications for utilization management and quality measurement. Data not provided in the input (such as specific ICD-10 pairings or payer-specific reimbursement rates) is noted as unavailable for this summary.
Billing Code Overview
CPT code 29874 describes an arthroscopic procedure in which the provider inspects the interior of the knee joint with an arthroscope to locate and remove loose or foreign bodies. These loose bodies can include fragments of cartilage or other debris that cause pain, inflammation, scar tissue formation, adhesions, and restricted range of motion.
Service Type: Arthroscopic knee procedure — removal of loose or foreign body
Typical Site of Service: Ambulatory surgery center or hospital outpatient department
Clinical & Coding Specifications
Clinical Context
A 42-year-old recreational athlete presents with persistent medial knee pain, intermittent swelling, and mechanical catching after a twisting injury eight weeks prior. Conservative care including rest, physical therapy, nonsteroidal anti-inflammatory drugs, and targeted intra-articular corticosteroid injection provided only temporary relief. Clinical exam demonstrates joint line tenderness and a positive McMurray test. MRI of the knee shows an intra-articular loose body adjacent to the medial femoral condyle and small chondral fragment. The orthopedic surgeon schedules an arthroscopic diagnostic and therapeutic procedure.
The patient arrives to an ambulatory surgical center on the day of surgery. Preoperative consent and timeout are completed. Under regional or general anesthesia, the surgeon performs diagnostic arthroscopy of the knee using an arthroscope, inspects all compartments, identifies loose bodies and fragmented cartilage, and removes loose and foreign bodies with arthroscopic graspers and shaver. Hemostasis is obtained, portals are closed, and the patient is transferred to recovery with routine postoperative instructions and a standard rehabilitation plan focusing on range of motion and gradual return to activity.
Typical site of service is an outpatient ambulatory surgical center or hospital outpatient department. The service type is a minimally invasive arthroscopic procedure (diagnostic and removal of loose bodies) of the knee.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 |