coderguy1939
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Hope I can get some help with this one. We're having trouble getting paid for 29826 with arthroscopic rotator cuff repair for Worker's Comp carriers that follow NCCI guidelines. 29827 is not on the OMFS schedule so we submit 29909 with a comparable code of 23410 or 23412 depending on whether or not the rotator tear is acute or chronic.
Per NCCI, 29826 bundles with 23410 and 23412 and CMS is not following the AMA or AAOS in using 29822 or 29823 for subacromial decompression.
We're appealing the denials and pointing out that 23410 and 23412 are comparable codes being used for valuation, but haven't been very successful in getting paid.
Anyone else dealing with this issue and how are you handling it?
Thanks.
Per NCCI, 29826 bundles with 23410 and 23412 and CMS is not following the AMA or AAOS in using 29822 or 29823 for subacromial decompression.
We're appealing the denials and pointing out that 23410 and 23412 are comparable codes being used for valuation, but haven't been very successful in getting paid.
Anyone else dealing with this issue and how are you handling it?
Thanks.