Arthroscopic and Mini Open Rotator Cuff

cwilson3333

Expert
Messages
273
Location
Hamilton, VA
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Work Compensation Denied by charges for Arthroscopic procedures performed with mini-open rotator cuff repair [23412]

Submitted 29822
for Biceps Tenotomy and Labral Debridement [High grade biceps tear/fraying and labrum fraying

Submitted 29826
for Subacromial Decompression and Resection Subacromial spur

Reason for denial
Per CPT, do not report arthroscopy procedure, when it preceeds an "arthrotomy" in the same session or same compartment

Do I have an appeal??
 

talitha82

Guest
Messages
50
Location
Helena, MT
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Yes- you can bill 23412 with 29826 as long as you have a supporting code with it (29826 can only be billed with a certain list of codes, and 29822 happens to be one of them.) You wouldn't be able to bill 29826 alone with 23412, but since you have the 29822 in there, I believe you have the ability to appeal.
 
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