Cpt 2012

[LEEANN]

CPT 2012 CONVERTED CODE 29826 TO AN ADD-ON CODE TO BE LISTED IN ADDITION TO THE CODE FOR THE PRIMARY PROCEDURE. IT SPECIFICALLY INDICATES THAT 29826 IS TO BE USED IN CONJUNCTION WITH 29806-29825, 29827 AND 29828.
CCI EDITS INDICATED THAT 29826 CAN BE REPORTED WITH CPT 23412, WHEN APPROPRIATE, BY APPENDING MODIFER -59.
WHICH GUIDELINES ARE APPROPRIATE TO FOLLOW?
Thank you.

[ajs]

Originally Posted by LEEANN

CPT 2012 CONVERTED CODE 29826 TO AN ADD-ON CODE TO BE LISTED IN ADDITION TO THE CODE FOR THE PRIMARY PROCEDURE. IT SPECIFICALLY INDICATES THAT 29826 IS TO BE USED IN CONJUNCTION WITH 29806-29825, 29827 AND 29828.
CCI EDITS INDICATED THAT 29826 CAN BE REPORTED WITH CPT 23412, WHEN APPROPRIATE, BY APPENDING MODIFER -59.
WHICH GUIDELINES ARE APPROPRIATE TO FOLLOW?
Thank you.

I would follow the CPT guidelines, the CCI edits may not have caught up to the changes.

[mitchellde]

Are you looking at the first quarter 2012 CCI edits?

[LEEANN]

Yes, I am using the first quarter of the 2012 CCI Edits.

[ajs]

Originally Posted by LEEANN

CPT 2012 CONVERTED CODE 29826 TO AN ADD-ON CODE TO BE LISTED IN ADDITION TO THE CODE FOR THE PRIMARY PROCEDURE. IT SPECIFICALLY INDICATES THAT 29826 IS TO BE USED IN CONJUNCTION WITH 29806-29825, 29827 AND 29828.
CCI EDITS INDICATED THAT 29826 CAN BE REPORTED WITH CPT 23412, WHEN APPROPRIATE, BY APPENDING MODIFER -59.
WHICH GUIDELINES ARE APPROPRIATE TO FOLLOW?
Thank you.

This is what is listed under the coding tips in Encoder Pro for 29826:

"This code has been revised for 2012 in the official CPT description. As an "add-on" code, 29826 is not subject to multiple procedure rules. No reimbursement reduction or modifier 51 is applied. Add-on codes describe additional intra-service work associated with the primary procedure. They are performed by the same physician on the same date of service as the primary service/procedure, and must never be reported as a stand-alone code. Use 29826 in conjunction with 29806-29825, 29827, or 29828. Surgical arthroscopy always includes diagnostic arthroscopy. According to CPT guidelines, cast application or strapping (including removal) is only reported as a replacement procedure or when the cast application or strapping is an initial service performed without a restorative treatment or procedure. See "Application of Casts and Strapping" in the CPT book in the Surgery Section, under the Musculoskeletal System. For open acromioplasty with decompression, see 23130. For coracoacromial ligament release, with or without acromioplasty, see 23415. For open reconstruction of complete shoulder rotator cuff avulsion, chronic, including acromioplasty, see 23420."

And yes the CCI edits may not have been updated since this is new for 2012 on this code.