Wiki 29826

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Loogootee, IN
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All of my providers like to bill codes 29827, 29828, and 29826 together for a shoulder surgery for rotator cuff tear, biceps tendonosis, and impingement. CPT code 29826 I have always had trouble with most insurances denying this code saying it's bundling with payment for 29827. I do have a 59 modifier attached to 29826 and 29828 when billing. Any advise on this?
 
There is no edit between these codes so why do you feel 29828 & 29826 need a -59? That could be part of your problem right there. Last fall BXBS decided that 29826 would always bundle with 29827 even though there is no pathological relation. Unless you remove the inflamed bursa and hooked acromion, the impingement is not going to be treated. The current president of AAOS has already written BXBS about how this negatively affects their patients. We can only hope that BX will reverse their internal decision and let pathology dictate proper procedures. Changing gears. Maybe I am reading this wrong, but 29828 is the procedure of last resort. If the biceps tendon is too frayed or degenerated, then a tenodesis becomes the physicians last option.
 
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