Summary & Overview
CPT 29892: Arthroscopic Repair of Ankle Osteochondral Defects
CPT code 29892 represents arthroscopic inspection and repair of osteochondritis dissecans in the ankle, including fixation of cartilage to bone with screws when indicated. This procedure addresses osteochondral defects of the talar dome and tibial plafond and is a key intervention for preserving joint function and preventing progressive degeneration. Nationally, the code is used across hospital outpatient departments and ambulatory surgery centers for operative management of ankle cartilage injuries. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise clinical and billing reference to CPT code 29892, including standard service context, typical sites of service, and common modifiers used with arthroscopic fixation procedures. The summary highlights benchmarks relevant to utilization and payer coverage patterns, clinical indications for coding, and policy considerations that affect authorization and payment. Data not available in the input is clearly noted where applicable, and the content is oriented for national audiences seeking a concise policy and clinical snapshot rather than state-level guidance.
Billing Code Overview
CPT code 29892 describes an arthroscopic procedure in which the surgeon inspects the interior of the ankle joint to identify and treat osteochondritis dissecans affecting the talar dome and tibial plafond. The procedure includes debridement and repair of cartilage defects and, when necessary, insertion of screws to secure cartilage to bone.
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Service type: Arthroscopic surgical repair of osteochondral defects of the ankle (operative arthroscopy with fixation)
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Typical site of service: Hospital outpatient department or ambulatory surgery center
Clinical & Coding Specifications
Clinical Context
A 24-year-old recreational soccer player presents with persistent deep ankle pain, swelling, and intermittent catching after an inversion injury three months earlier. Examination reveals focal talar dome tenderness and decreased ankle range of motion. Advanced imaging (MRI) demonstrates an osteochondral lesion of the talus with unstable cartilage fragment. The orthopedic foot and ankle surgeon schedules an arthroscopic procedure.
The patient arrives to the ambulatory surgery center on the day of surgery. After preoperative verification and regional or general anesthesia, the surgeon performs diagnostic ankle arthroscopy using standard anteromedial and anterolateral portals to visualize the talar dome and tibial plafond. Unstable osteochondritis dissecans fragments are identified. The surgeon performs debridement and microfracture or fixation of osteochondral fragments as indicated and inserts headless screws to secure cartilage/osseous fragments to subchondral bone when required. Intraoperative fluoroscopy confirms hardware position. The procedure is coded as 29892 for arthroscopy with fixation of osteochondral defects of the talus/tibial plafond. Postoperative recovery includes neurovascular checks, splinting or boot immobilization, weight-bearing restrictions per fixation stability, and outpatient orthopedic follow-up for wound check and progressive rehabilitation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 |