February 2, 2023
Our surgeon documented in the procedure title that he performed an arthroscopic ORIF of a tibial plateau subchondral fracture with injection of calcium phosphate, and he wants to report CPT code 29855 (Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy). I do not see an actual ORIF but do see the injection of the calcium phosphate.
I believe I read somewhere that this is not correct, but I cannot find my source.
You are correct to question this and yes, CPT has addressed this several times in their AMA CPT Assistant publication in recent years. In 2019, they advised that CPT code 29855 is not the correct code for the brief description you provide.
In January 2022, CPT published Category III code 0707T (Injection(s), bone substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization) as the code to use to report this work.
*This response is based on the best information available as of 02/02/23.