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Wiki 29823

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lburgos31

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I want to be very clear on this because I feel like I've been told different answers/advice.

What would constitute billing 29823 with 29827,29826,29824...OR any combination of these codes with 29823?
 
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I was just about to post a question regarding this!!

To me and from all my research (which i'm still questioning), I bill CPT 29823 with a 29827,29826, 29824 and sometimes 29828 (23430) only if my provider debrides something other than the those structures they are later repairing.

op report example: "A posterior viewing portal was created diagnostic arthroscopy was performed. There was a high-grade tear of the supraspinatus and infraspinatus on the articular side. This was debrided back to stable edge. It appeared to be a small full-thickness component. This was tagged with a Prolene stitch for evaluation on the bursal side. There was an unstable superior labral tear. The long head of biceps was released using an up-biting basket. The superior labrum was debrided back to stable edge. There was significant degenerative anterior bucket-handle labral tearing, which was debrided back to stable edge. There was a posterior inferior labral tear which debrided back to stable edge. The posterior labrum was debrided back to stable edge. This tear with degenerative I do not think he would benefit from repair."

Everything besides what I made blue/bold doesn't count toward the extensive debridement. Now if the only everything was the same but they didn't debride the posterior portion of the labrum it doesn't count as extensive, that would be limited (29822).

*Also what do we say about this scenario...
My physician performed a bicep tenodesis (29828) but prior to he did an extensive debridement; "There was thickening of the rotator interval, this was extensively released medial to the coracoid and lateral to the biceptal groove. There was tearing involving the superior labrum that extended into the bicep tendon. This was extensively debrided."​


I am praying someone can also confirm if my understanding of this is correct!!!
 
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Keep in mind that any debridement that is associated with a restorative procedure is not counted towards 29822 and 29823. Before performing a rotator cuff repair the surgeon will "debride" the frayed tendon, and the bone where the anchor will be placed. Same with a biceps tenodesis procedure and other restorative procedures. 29823 is usually considered two or more "soft" tissues or one or more "hard" tissues. Just because bone is debrided does not automatically mean 29823. Think of a Type III acromion. A significant amount of bone to remove. That would count. Some insurance companies don't think there is enough tissue left for 29823 after performing 29827, 29824 and 29826 which I don't agree with. If the debridement is associated with a restorative procedure, it can't be counted towards 29823 and not all insurance companies will pay on 29823 yet either even though CMS fixed that problem three years ago.
 
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