Wiki Cpt 29822

[nmoretto]

Anyone having issues getting CPT 29822 paid with other shoulder codes? We used to be able to bill 29822 with modifier 59 & suddenly we are getting denials from a couple payers. I've been looking for new updates from Medicare & can't find anything....Anyone have any info?

 

[Orthocoderpgu]

You should not be billing 29822 with shoulder procedures. This will always be denied as bundled. There has been some recent action on getting 29823 paid and not bundled. On 7/1/2016 the edits with 29823 and shoulder procedures was removed by CMS. Keep in mind, that the debridement needs to be unrelated to any other procedure. Example, the doc will debride the bone in preparation for a biceps tenodesis or a rotator cuff repair. So this debridement would not be reported with 29823 since it's part of performing the procedure. The debridement must be unrelated to any other restorative procedure.