Wiki Arthroscopic shoulder procedure to open procedure

[boyett]

Can someone please help me with this case I am a tad confusion about what I should actually report given this is a medicare patient and 2 of the codes have bundled edits Thank You

arthroscopic synovectmy of the glenohumeral joint,extensive 29821
arthroscopic subacromial decompression with acromioplasty 29826
open rotator cuff repair 23412
open mumford 23120

all help is appreciated

thanks

 

[Orthocoderpgu]

Bill 23412 & 23120

Keep in mind that Medicare starting this year officially announced that they consider the shoulder one anatomic location. No, I don't agree with this decision at all, because it's not. It's much more complicated than that. Due to that decision, anything that hits an NCCI edit cannot be billed on the same shoulder. The only way that Medicare is going to allow a -59 modifier is if the procedure is performed on the opposite shoulder starting this year. For Medicare and those that follow Medicare, when it comes to shoulder procedures, anything that hits an edit is not billable.