Provider did Arthroscopic right shoulder Labral repair and Remplissage. I am struggling with a code for the Remplissage. The provider wants me to bill either 29827 or unlisted code. With everything I've read, I believe it should be 29806 and add 22 modifier. What codes are you all using? Below is the OP note if that helps.
1. Right shoulder arthroscopic revision labral repair.
2. Right shoulder arthroscopic Remplissage procedure.
3. Right shoulder arthroscopic extensive debridement
DESCRIPTION OF PROCEDURE: Patient was placed in the lateral decubitus position ensuring all bony prominences well-padded. His neck was in neutral alignment. He was thoroughly cleansed with hydrogen peroxide and subsequently prepped and draped in normal sterile fashion. Surgical time-out was performed with two patient identifiers confirming correct laterality and procedure to be performed. His shoulder joint was insufflated with 60 mL of saline. Posterior portal was established. Diagnostic arthroscopy was commenced with findings of no cartilaginous lesions of the humeral head except for the Hill-Sachs lesion. Subcritical bone loss of the anterior glenoid. Full-thickness anterior labral tear with failure of repair of previous suture anchors or previous suture repair. The Hill-Sachs lesion was identified. I used a curette and bur to create a bleeding bone edge. I then subsequently placed two Arthrex 2.6 fiber tack anchors of the medial and lateral aspects of the Hill-Sachs lesion to tie at the end of the case. I then established the anterior portals. I removed the previous sutures. I created a nice bleeding bone edge of the anterior glenoid with a combination of tissue elevator and a rasp and shaver. A total of four 1.8 knotless fiber tack suture anchors were placed into the labrum and capsule itself. I ensured that I got a large bite of the capsule and prior to tensioning pulled up on the capsule and labrum to create a nice bumper affect. This was achieved with four fiber tack anchors. Pictures were obtained. I then subsequently tied the fiber tack anchors to each other's working stitch to create a compressive effect and placed down the supraspinatus tendon onto the Hill-Sachs lesion thus closing that Hill-Sachs defect. Final pictures were obtained. Portal sites were closed. Xeroform, 4x4, ABD and tape dressing was placed. He was placed into a sling.
1. Right shoulder arthroscopic revision labral repair.
2. Right shoulder arthroscopic Remplissage procedure.
3. Right shoulder arthroscopic extensive debridement
DESCRIPTION OF PROCEDURE: Patient was placed in the lateral decubitus position ensuring all bony prominences well-padded. His neck was in neutral alignment. He was thoroughly cleansed with hydrogen peroxide and subsequently prepped and draped in normal sterile fashion. Surgical time-out was performed with two patient identifiers confirming correct laterality and procedure to be performed. His shoulder joint was insufflated with 60 mL of saline. Posterior portal was established. Diagnostic arthroscopy was commenced with findings of no cartilaginous lesions of the humeral head except for the Hill-Sachs lesion. Subcritical bone loss of the anterior glenoid. Full-thickness anterior labral tear with failure of repair of previous suture anchors or previous suture repair. The Hill-Sachs lesion was identified. I used a curette and bur to create a bleeding bone edge. I then subsequently placed two Arthrex 2.6 fiber tack anchors of the medial and lateral aspects of the Hill-Sachs lesion to tie at the end of the case. I then established the anterior portals. I removed the previous sutures. I created a nice bleeding bone edge of the anterior glenoid with a combination of tissue elevator and a rasp and shaver. A total of four 1.8 knotless fiber tack suture anchors were placed into the labrum and capsule itself. I ensured that I got a large bite of the capsule and prior to tensioning pulled up on the capsule and labrum to create a nice bumper affect. This was achieved with four fiber tack anchors. Pictures were obtained. I then subsequently tied the fiber tack anchors to each other's working stitch to create a compressive effect and placed down the supraspinatus tendon onto the Hill-Sachs lesion thus closing that Hill-Sachs defect. Final pictures were obtained. Portal sites were closed. Xeroform, 4x4, ABD and tape dressing was placed. He was placed into a sling.