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Wiki Arthroscopic RC vs mini open Bicep Tendon Repair

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mindy071971

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I was wondering what other coders were billing for these procedures. If the surgeon does an arthroscopic rotator cuff repair and then does an mini open bicep tendon repair, which one of them would you bill. We are seeing this on a regular basis now, so any insight would be great Thanks
 
Are you showing there is an NCCI edit with the two codes you are billing? I didn't think there was a bundling issue for the procedures in question?
 
No, since we are the anesthesiologist, we can only bill one procedure. When we have a procedure that starts out as a lap and changes to an open procedure we code the open procedure. So in this case we have a ARC and a mini open bicep repair, should we code the bicep repair since it is an open procedure?
 
Both codes appear to have the a base unit of 5. I guess you could pick the more demanding procedure to base the anesthesia code on.

01716 Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenodesis, rupture of long tendon of biceps

01630 Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; not otherwise specified
 
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