Arthoscopically -assisted ORIF of greater tuberosity fracture

[vhuscher]

I am questioning how to code this, since the use of the portals would not support and open procedure. He does this reduction through 2 accessory lateral portals and provisionally pinned in place. He then places a 2.6 mm knotless suture anchors medial and posterior most margins of the fracture , passes each around the fracture fragment with suture Lasso. Does some sub acromial debridement of the bursa and closes. Cpt code 23630 was suggested but, the provider only uses the portals.

 

[NRaizman]

Would generally consider that 29999 with comparison 29827 or 29827+22.

There's a little leeway depending on how the surgeon describes the portals/incisions.
If the surgeon is educated enough in coding to describe the procedure as debridement and cuff repair around the fracture as well as additional complex work of pinning the fracture, that is an easier lift to code 29827+22 and if he/she describes the debridement/cuff fixation work as if it's a cuff repair and then describes a separate incision or portal enlargement to reduce and fix the fracture, you may be able to code both ORIF and cuff repair with a -59. This is not something you'd be able to do post-hoc though, as it's really a matter of writing the report in a way that can be interpreted to your advantage.

 

[vhuscher]

Would generally consider that 29999 with comparison 29827 or 29827+22.

There's a little leeway depending on how the surgeon describes the portals/incisions.
If the surgeon is educated enough in coding to describe the procedure as debridement and cuff repair around the fracture as well as additional complex work of pinning the fracture, that is an easier lift to code 29827+22 and if he/she describes the debridement/cuff fixation work as if it's a cuff repair and then describes a separate incision or portal enlargement to reduce and fix the fracture, you may be able to code both ORIF and cuff repair with a -59. This is not something you'd be able to do post-hoc though, as it's really a matter of writing the report in a way that can be interpreted to your advantage.

Thanks I appreciate your help with this.