Orthopedic Coding Alert

Question: Can we report 29827 with modifier -22 (Increased Procedural Services:...) or -52 (Reduced Services:...) for "partial rotator cuff repair." The operative note is as follows:

"......the greater tuberosity was debrided as was the rotator cuff and old suture material was removed. Anchors were placed in the greater tuberosity. Sutures were passed and tied affecting a nice repair of the anterior portion of the rotator cuff to about the posterior 1/3 of the supraspinatus. The posterior 1/3 of the supraspinatus and subscap were not repairable. The shoulder was then irrigated and wounds were closed."

New York Subscriber

Answer: You report 29827 (Arthroscopy, shoulder, surgical; with rotator cuff repair) regardless of how many tendons of the rotator cuff are repaired. The rotator cuff repair remains simple even if not fully repaired, so modifier -22 may not be appropriate for every situation. You append modifier 22 only if your surgeon has adequately documented the procedure to be extraordinarily complex.