2nd request shoulder coding

kdahlen

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Our doc did a distal clavicle excision of the shoulder via scope 29824 and an ossicle excision open wants to bill this seperate was hoping for some help with a code.

OP report :Hypertrophic OA of the distal clavicle was encountered. Through a
sperate naterior portal i brought in motorized instrumentation to debride the joint and remove the lateral 9 to 10 mm of claivle while preserving the joint capsule. there was a seperate ossicle in the posterior/superior distal clavicle that I was not able to debride with the arthroscope but i felt warrented open excision superiorly. This was preformed after rotator cuff repair. A small 1.5 cm skin incision was made over the dorsal aspect of the distal clavicle and dissection carried down through the dorsal AC joint capsule to excise this seperate bony ossicle which was not obtainable arthroscopically.

Thanks
Kathy
 

Kate Tierney

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This is what the CCI Manual has to say -

E. Arthroscopic Procedure Converted to Open Procedure

If an arthroscopic procedure fails and is converted to an open procedure, only the open procedure is reportable. Thus, arthroscopic procedures are bundled into open procedures. If an arthroscopic procedure and open procedure are performed on different joints, the two procedures may be separately reportable with anatomic modifiers or modifier -59.


Hope this helps!
 

trose45116

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i dont see how you can say the artho part of the surgery failed. the clavicle was accomplished. i dont think you would be able to bill the open part as its being done on the same part of the body. this is just my opinion.
 

mbort

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i dont see how you can say the artho part of the surgery failed. the clavicle was accomplished. i dont think you would be able to bill the open part as its being done on the same part of the body. this is just my opinion.
The op note that was posted does state "there was a seperate ossicle in the posterior/superior distal clavicle that I was not able to debride with the arthroscope but i felt warrented open excision superiorly", therefore I agree with Kate's response, this was an arthroscopic procedure converted to open to complete, therefore you would only code for the open portion of the procedure.
 
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