CPT Code 29999: Unlisted procedure, arthroscopy

Yes, when billing CPT code 29999, you should submit a comparable CPT code that reflects a similar surgical procedure in complexity and scope. Include your proposed fee, a detailed description, and the rationale for using an unlisted procedure code. This helps payers assign reimbursement on a case-by-case basis.

Yes, prior authorization is strongly advised for CPT 29999 by nearly all payers, especially commercial insurers and Medicare Advantage plans. This is due to its unlisted status, which requires a review of documentation before approval. Failing to obtain authorization may result in claim denial.

No, CPT code 29999 is designated for arthroscopy procedures only. If you are billing for an unlisted open procedure, use CPT 27599, which applies to unlisted procedures of the lower extremity. Always ensure the code aligns with the surgical approach to maintain accurate billing and coding practices.