29826 - Question on 29826

[GraceW]

Question on 29826 (Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (i.e., arch) release, WHEN performed (list separately in addition to code for primary procedure).

I know this is an add on code for 2012. Do my doctors have to perform the coracoacromial ligament release when we bill this. I am reading the wording to indicate WHEN it is performed and not necessarily having been done. Please help..................

 

[OCD_coder]

The coracoid ligament release is inclusive to the decompression and acromioplasty, so it is not a seperately billable. What the description is saying with "list separately...." is there must be a primary/parent code (see the parenthetical directions with 29826) in order to bill this code. It cannot be billed alone. See the below reference if that is the only procedure done at a surgical session.

Per the AAOS:

http://www.aaos.org/news/aaosnow/jan12/managing4.asp

CPT code 29826 should not be reported with any procedure other than those identified as appropriate parent codes. It is not an add-on code to CPT code 23410 or 23412, and an unlisted code may not be reported to reflect this work. Instead, append modifier 22 or report 29822 or 29823 (limited or extensive débridement) as appropriate.

 

[GraceW]

Thanks Michelle,

I think I get it. I have an acquaintance who is a CPC with more years experience than I have and she is telling me my doctor has to note in his operative note that the coracoacromial ligament was also released along with the subacromial decompression. But if the coracoarcomial ligament release is inclusive I am assuming it is included in 29826, when billed with parent procedures.

Grace