Orthopedic Coding Alert

Question: Ive recently been told that when a partial claviculectomy is done arthroscopically, we should use the unlisted arthroscopic code (29909). My argument is that 23120 states claviculectomy; partial. It does not specify an open procedure, only that a portion of the clavicle was removed. If it does not specify open, why cant 23120 be used with the arthroscopic claviculectomy? Using an unlisted procedure, especially with scope procedures, is always fraught with denials even when we submit supporting documentation and an explanatory letter.

Oregon Subscriber

Answer: The procedure you describe is an arthroscopic Mumford repair. Code 23120 (claviculectomy; partial) remains the most accurate code to use for the procedure. It is similar in concept to, say, 27425 (lateral retinacular release [any method]). It should only be a matter of time before CPT adds the language any method to 23120, which would certainly make things easier. In the meantime, when dealing with nonspecific codes such as these, you must continue sending in supporting documentation and additional explanations of what was done in the operative setting.