Arthroscopic Shoulder Labrum repairs

JenReyn99

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I've been looking for guidance on 29806 vs 29807, and everywhere it seems like there is a lot of debate and confusion on which one to use when. I am newer to Ortho, and I want to make sure that I am coding these correctly. For instance, I have a report right now that says this:

Arthroscope was directed into the glenohumeral space revealing the biceps labral complex completely detached off the superior labral aspect. Also, there was evidence of an anterior labral tear and then inferior labral tear, as well as posterior labral tear. The rim of the glenoid was repaired. Successive suture anchors were placed, initially starting at the 3 o'clock position, 4 o'clock position, 5 o'clock position. Bio-Suture Tak anchors were placed using a combination of suture lasso and bird's beak passing device. The inferior and posterior labral repair was performed at the 6 o'clock, 7 o'clock, 8 o'clock, 9o'clock, and 10 o'clock position using Bio-Suture Tak anchors and bird's beak suture passing device, as well as ___ and suture lasso devices. These were tied in arthroscopically, providing a stable rim of the glenoid with the labrum, and then the biceps labral complex was repaired at the 11 o'clock and 1 o'clock position using Bio-Suture Tak anchors at the 11 o'clock and 1' oclock postion.

he also resected the distal clavicle and decompressed the subacromial space

So the codes I am coming up with right now are:
29806
29824
29826

How do you know when it is a SLAP tear if the doc doesn't state this? I don't have any idea what the criteria for a SLAP tear are, and when that criteria warrants the 29807. I feel very lost on this subject, as well as on guidelines for arthroscopic shoulder codes that bundle. Does anyone have an answer for this, and some good resources I can use to wrap my head around this all a little better. I have no resources and no guidance whatsoever, so I need all the help I can get. Thank you so much!
 

PLAIDMAN

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Medicare includes those 2 codes (29807 & 29806).
AAOS says you can code these 2 codes together IF there is an injury to the capsule in an area OTHER than the SLAP.

A SLAP is "Superior Labrum Anterior to Posterior", if I have a tear of the Labrum anywhere in that area I code a SLAP (840.7). There are several different types of SLAP lesions, but for coding purposes I would stick with definition above.

The most info I have found on this subject is through AAOS, no one else seems to give as detailed info on the subject.

If you have a SLAP tear as well as an injury to the labrum and capsule that is say inferior/posterior then I would code both. I would use an unspec. code for the capsule injury (840.8) or if it is degenerative or chronic 718.01

If you google you can find AAOS articles on the subject. In some cases I have had to send AAOS articles to get these paid together.

Hope that helps a little
 

JenReyn99

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That helps alot! Thank you! I am still struggling to get my bearings, going from intestines to bones is a big switch for me! I appreciate the help a lot! :0)
 

JenReyn99

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Can anyone post a link to specific articles from the AAOS stating that 29806 is a valid code for labrum repairs? I am having a hard time getting these paid by certain payers under the 29806.
 
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