Summary & Overview
CPT 29885: Arthroscopic Treatment of Osteochondritis Dissecans, Knee
CPT code 29885 represents arthroscopic management of osteochondritis dissecans in the knee, including excision of unstable cartilage, drilling to stimulate healing, bone grafting, and possible screw fixation. This procedure is clinically important for patients with symptomatic osteochondral lesions because it can reduce pain and improve function while avoiding open surgery in many cases. Nationally, coverage and utilization of arthroscopic osteochondral repair affect postoperative outcomes, site-of-service decisions, and surgical resource planning.
Key payers typically included in analyses are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical indications and the service setting, payer coverage considerations, common modifiers associated with surgical services, and guidance on where to look for coding and billing clarifications. The publication also outlines benchmarks and policy topics relevant to surgical management of knee osteochondral lesions, such as reimbursement variability across payers, documentation expectations for medical necessity, and implications for ambulatory versus hospital outpatient settings. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 29885 describes an arthroscopic procedure to treat osteochondritis dissecans of the knee. The surgeon inspects the intra-articular knee structures with an arthroscope, removes unstable or detached cartilage and bone fragments, drills or microfractures damaged cartilage to promote healing, places bone graft material as needed, and may insert fixation screws to secure the repair. The procedure aims to relieve pain and restore joint mobility by encouraging reattachment of bone and cartilage.
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Service type: Arthroscopic knee debridement and fixation for osteochondral lesion
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Typical site of service: Hospital outpatient department or ambulatory surgery center
Clinical & Coding Specifications
Clinical Context
A 16-year-old competitive adolescent athlete presents with several months of progressive knee pain, intermittent swelling, and mechanical catching after a twisting injury during sport. Clinical evaluation and knee radiographs suggest a focal osteochondral lesion. Magnetic resonance imaging confirms an osteochondritis dissecans lesion of the medial femoral condyle with partial separation of cartilage and subchondral bone. After failed conservative management including activity modification, physical therapy, and bracing, the orthopedic surgeon schedules an arthroscopic procedure.
The procedure is performed in an ambulatory surgery center or hospital operating room under regional or general anesthesia. The surgeon uses standard arthroscopic portals to evaluate the joint, excises unstable cartilage fragments, performs microfracture or drilling of the lesion bed to stimulate revascularization and bone healing, applies bone graft material as needed, and, if indicated, places fixation such as bioabsorbable or metal screws to secure a fragment. Postoperative workflow includes recovery room monitoring, analgesia, weight-bearing restrictions, and a documented operative report describing findings, techniques, grafting, and fixation. Typical post-op follow-up includes immobilization, progressive range-of-motion and strengthening with physical therapy, and serial radiographs to assess healing.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component |