Arthroscopic hip surgery is generally a very affordable procedure. Due to insurance coverage issues, however, some patients find themselves having to pay for part of their surgical procedure. Even when deductibles have been met, and full coverage is anticipated, some insurance companies have 'fine print' policies that leave patients exposed financially. We know how to maximize your benefits.
We have many years of experience in dealing with insurance companies and advocating for our patients. Let us look at your particular coverage policy and appeal for your full coverage.
Even if we do not accept your primary insurance carrier, we may accept your secondary insurance or be able to work out an out-of-network coverage plan for you. If you do not have insurance coverage, allow us to assess your unique situation and work out an arrangement that is feasible for you.
Our bottom line is: our first priority is to figure out a way to get you the care you need and improve your health, and secondly, utilize all of our resources to make healthcare affordable.
Please contact our Billing Manager, Diane at (770) 363-8770.
Don't be fooled into not contacting us even if we appear to be "out of network." We are very experienced in dealing with your insurance company and working things out.
Many of the hip arthroscopy billing codes we submit to your insurance carrier are considered "unlisted" ie, CPT 29999. This means that the codes are not the standard ones they recognize. This is because we are able to do advanced procedures that some insurance carriers do not recognize.
The codes we use and the procedures we do have been around for many, many years, yet some of the insurance companies have not adopted them nor updated their systems.
The Current Procedures
Terminology (CPT) Guidelines for hip arthroscopy only lists seven recognized codes.
- CPT 29860 Hip arthroscopy: diagnostic (look in and see)
- CPT 29861 Hip arthroscopy: removal of loose bodies/fragments
- CPT 29862 Hip arthroscopy: debridement/shaving out loose tissue
- CPT 29863 Hip arthroscopy: synovectomy (cleaning out inflammation)
- CPT 29914 Hip arthroscopy: Femoroplasty, shaving femoral head/neck junction
- CPT 29915 Hip arthroscopy: Acetabuloplasty, shaving the socket rim
- CPT 29916 Hip arthroscopy: labral repair
- CPT 29999 Hip arthroscopy
- Repair of gluteus medius or minimus tendon tears
- Surgery for Ischiofemoral or Subspine impingement
- Labral Reconstruction with allograft
- Release of snapping hip/iliopsoas tendon
- Microfracture cartilage repair
- Arthroscopic cartilage transplantation
- Arthroscopic removal of heterotopic bone
- Debridement/repair Ligamentum Teres
The codes for some of the procedures you might need are UNLISTED.
That means that we have to formally APPEAL to your insurance company to cover you for these medically necessary codes. This appeal process can take weeks to months, but because we've done this so many times over the years, we are generally able to get it done faster than average.