Orthopedic Coding Alert

Reader Question:

Multiple Procedures

Question: One of our surgeons frequently performs the following multiple arthroscopic procedures on shoulders, for which there are no CPT codes:

arthroscopic anterior capsular labral reconstruction

arthroscopic posterior capsular reconstruction

inferior capsular plication

Code 29909 has to be used, but how many times can I use it on the same claim?

Kansas Subscriber

Answer: You should report 29909 (unlisted procedure, arthroscopy) only once to describe the multiple unlisted arthroscopic shoulder procedures your surgeon performs at a single operative session. As Im sure you are aware, you will need to submit a letter to the carrier explaining each component of the procedure and, if possible, equating it to a listed procedure in the CPT manual. Review the codes in the shoulder section with your surgeon and have him choose the code that should be used for comparative purposes for the capsular reconstruction and plication.

Answers to You Be the Coder and Reader Questions provided by Heidi Stout, CPC, CCS-P, coding and reimbursement manager at University Orthopedic Associates in New Brunswick, N.J.

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