Wiki Can 23412 still be used??

[taylov519]

The doctor did an arthoscopic acromioplasty, arthroscopic distal clavicle excision and also did a mini-open technique. When the doctor did the mini-open RCR; he found that it was irreparable. My question is would I still be able to bill the 23412 using a modifier like -22 because he did not repair it or use the unlisted code for this procedure. Any input would be great. Thanks.

 

[mbort]

The doctor did an arthoscopic acromioplasty, arthroscopic distal clavicle excision and also did a mini-open technique. When the doctor did the mini-open RCR; he found that it was irreparable. My question is would I still be able to bill the 23412 using a modifier like -22 because he did not repair it or use the unlisted code for this procedure. Any input would be great. Thanks.

and he didnt nothing while it was open?

Modifier 22 would not be appropriate as that is for procedures that are more complicated. I am thinking you may have meant -52

 

[taylov519]

Yup, you're right; I meant -52. This is what the op says for the rotator cuff-" Excess bursa was debrided fromthe subacroial space, exposing the rotator cuff tear, and it became quite evident that this tear was irreparable." Then he went into closing the incision.

 

[mbort]

Yup, you're right; I meant -52. This is what the op says for the rotator cuff-" Excess bursa was debrided fromthe subacroial space, exposing the rotator cuff tear, and it became quite evident that this tear was irreparable." Then he went into closing the incision.

based on that, I would not bill the 23412 even with a modifier 52. There isnt enough there to support it. You may want to just consider a diagnostic arthrotomy.