Orthopedic Coding Alert

Question: How should I code an arthroscopic excision of a bursa in the shoulder when surgical notes state that the physician did not perform a decompression? Kansas Subscriber Answer: Your code choice will depend on whether your physician performed a limited or extensive excision: • 29822 -- Arthroscopy, shoulder, surgical; debridement, limited • 29823 -- ... debridement, extensive. The debridement often requires an acromioplasty, which is code 29826 (Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with or without coracoacromial release). Keep these tips in mind, however, before adding 29826 to your claim: • Do not report 29826 if your surgeon's notes don't mention acromioplasty. • You cannot report 29826 with 29822. • You sometimes can report 29826 with 29823, depending on the circumstances. Example: If the physician completes both the acrominoplasty and debridement within the subacromial bursa, you'll report only 29823. If he completes acrominoplasty within the subacromial bursa [...]