Summary & Overview
CPT 29887: Arthroscopic Repair of Knee Osteochondritis Dissecans
CPT code 29887 denotes an arthroscopic knee procedure to identify intact osteochondritis dissecans lesions, stimulate cartilage healing via drilling, and secure cartilage to bone with screws. This code captures a minimally invasive joint-preserving repair technique used to relieve pain and restore function in patients with focal osteochondral defects. Nationally, accurate use of the code matters for tracking utilization of joint-sparing surgical approaches, aligning clinical documentation with billing, and ensuring consistent coverage decisions.
Key payers referenced include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical intent and typical care setting for the procedure, plus payer considerations and benchmarking context. The publication summarizes common modifiers and billing nuances, highlights where service lines and site-of-service decisions affect claim routing, and flags gaps where input data is not available. The content is intended to help billing teams, clinical coders, and policy analysts understand coding rationale, anticipate payer review points, and locate relevant reference material for claims and coverage discussions.
Data not available in the input: associated taxonomies, specific ICD-10 diagnoses, related codes, and payer-specific payment rates or coverage policies.
Billing Code Overview
CPT code 29887 describes an arthroscopic procedure on the knee to assess and treat intact osteochondritis dissecans lesions. The provider uses an arthroscope to inspect the cartilage and subchondral bone, performs drilling to stimulate healing of damaged cartilage, and inserts screws to secure cartilage fragments to the underlying bone, with the goal of relieving pain and improving joint mobility.
Service type: Arthroscopic surgical repair of knee osteochondral lesion
Typical site of service: Hospital outpatient department or ambulatory surgery center (knee arthroscopy setting)
Clinical & Coding Specifications
Clinical Context
A 16-year-old adolescent presents with several months of activity-related right knee pain, intermittent mechanical catching, and decreased range of motion after a sports-related twist injury. Physical exam shows joint-line tenderness and an effusion. MRI of the knee demonstrates an osteochondritis dissecans lesion of the medial femoral condyle with unstable cartilage fissuring but not complete fragment separation.
The orthopaedic surgeon performs an arthroscopic evaluation of the knee (29887 describes arthroscopic drilling and internal fixation of an intact osteochondritis dissecans lesion). Under general anesthesia in an outpatient ambulatory surgery center or hospital operating room, diagnostic arthroscopy is completed to assess lesion stability. The surgeon performs microfracture/drilling of the lesion to stimulate healing and inserts bioabsorbable or metal screws to compress and secure the osteochondral fragment. The procedure typically results in decreased pain and improved joint function, followed by a postoperative protocol of protected weight-bearing, physical therapy, and serial radiographic/MRI follow-up to confirm lesion healing.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normal or routine service | Use when this procedure is the primary, scheduled operative service without unusual circumstances |
22 | Increased procedural services | Use when operative time and complexity are significantly greater than usual due to extensive lesion size, scarring, or additional unplanned work |
52 | Reduced services | Use when the procedure is partially completed or limited (e.g., planned fixation attempted but abandoned) |
53 | Discontinued procedure | Use when the procedure is started but terminated due to extenuating circumstances not related to patient refusal |
62 | Two surgeons | Use when two surgeons of different specialties (e.g., pediatric orthopedist and sports medicine) actively participate and document distinct portions of the procedure |
63 | Procedure performed on infants less than 4 kg | Use when patient weight/age-specific reporting is required (rare for this code) |
76 | Repeat procedure by same physician | Use when the same surgeon repeats the procedure during the postoperative period (not commonly used for initial fixation) |
78 | Unplanned return to the operating room for a related procedure during the global period | Use when an immediate complication requires return to OR for management of the same knee |
79 | Unrelated procedure during global period | Use when an unrelated procedure on the same patient is performed during the global period (note: 79 is not listed in raw modifiers; do not apply if absent) |
RT | Right side | Use to designate the right knee as the operative site when laterality is required |
LT | Left side | Use to designate the left knee as the operative site when laterality is required |
50 | Bilateral procedure | Use when bilateral knee procedures are performed during the same operative session (rare for isolated OCD fixation) |
22 | Increased procedural services | Duplicate entry avoided; see above |
59 | Distinct procedural service | Use when a distinct, separate arthroscopic procedure is performed at the same session that is not normally bundled |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207X00000X | Orthopaedic Surgery | Primary specialty performing arthroscopic fixation of osteochondritis dissecans |
| 207XS0112X | Orthopaedic Sports Medicine | Subspecialists often perform arthroscopic knee preservation and fixation |
| 2080P0208X | Pediatric Orthopaedic Surgery | Pediatric orthopedists manage juvenile OCD lesions and growth plate considerations |
| 207Q00000X | Hand/Upper Extremity Orthopedics | Data not applicable; surgery typically performed by lower extremity specialists |
| 208600000X | Physical Medicine & Rehabilitation | Involved in postoperative rehabilitation planning |
Note: Only the most clinically relevant modifiers from the provided list are presented. Provider taxonomies reflect common specialties involved in diagnosis, surgery, and postoperative care.
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M92.50 | Juvenile osteochondrosis of unspecified site, unspecified knee | Common code for juvenile osteochondritis dissecans affecting the knee in adolescents |
M93.29 | Osteochondritis dissecans, other site | Used for osteochondritis dissecans when site unspecified or for coding variations |
M17.9 | Osteoarthritis of knee, unspecified | May be used in older patients with secondary degenerative changes related to chronic OCD |
S83.24 | Bucket-handle tear of medial meniscus, current injury | Meniscal tears can coexist with OCD lesions and may be addressed arthroscopically during the same session |
M25.261 | Pain in right knee | Symptom code frequently reported alongside definitive diagnosis during initial encounters |
M25.262 | Pain in left knee | Symptom code for left-sided presentations |
S83.241 | Complex tear of medial meniscus, current injury | Meniscal pathology often evaluated and managed concurrently with OCD fixation |
M22.9 | Disorder of patella, unspecified | Associated knee cartilage/patellofemoral disorders considered in differential diagnosis |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
29870 | Arthroscopy, knee, diagnostic, with/without synovial biopsy | Often performed immediately before definitive fixation to inspect the joint and document lesion characteristics |
29875 | Arthroscopy, knee, drilling of osteochondritis dissecans lesion (separate code for drilling only) | Performed when drilling/microfracture is performed without internal fixation; may be part of the same surgical strategy if fixation not required |
29881 | Arthroscopy, knee, synovectomy, limited | May be performed during the same session to remove inflamed synovium or loose bodies encountered during arthroscopy |
20690 | Insertion of implant (e.g., pin, screw) without open approach; minor | Used for percutaneous screw insertion in some practices when fixation is performed arthroscopically with implant placement documentation |
99024 | Postoperative follow-up inpatient or observation | Used for global period postoperative visits in certain inpatient/observation settings (billing context varies by payer) |