Orthopedic Coding Alert

Question: How can we code an open tenolysis of biceps tendon done during a scope surgery? The surgeon made multiple attempts to mobilize the long head of the biceps and harvest it from the wound; the tendon was quite shredded and the attempts to mobilize it ended up rupturing it distally; so he ended up doing a tenolysis instead of a tenodesis.

Arizona Subscriber

Answer: Your surgeon here is not doing a tenolysis but a tenotomy as the tendon ruptured. There is no code for arthroscopic biceps tenotomy. You report code 29999 (Unlisted procedure, arthroscopy) with a comparison to the open code of 23440 (Resection or transplantation of long tendon of biceps). If it is only a tenolysis, you would report code 29822 (Arthroscopy, shoulder, surgical; debridement, limited) or possibly 29823 (Arthroscopy, shoulder, surgical; debridement, extensive) depending upon the extent of debridement.