Wiki CPT for scope repair shoulder labral tear anterior/posterior

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RebeccaMoney

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Is this 29807? Or is ther other labral tears besides SLAP that would be anterior/posterior? I'm assuming this is for inferior labral and in that case would it be 29806 only? My doctor wants to put mod 22 with 29806 if it doesn't cover both anterior & posterior.
thanks,
 
When Dr. William Beach M.D. created the arthroscopic CPT codes for the shoulder his intention was to divide the shoulder into an upper half and lower half. Work performed on the upper would be reported with 29807 and lower 29806. What your most likely dealing with is a Type II SLAP tear. Using modifier -22 would not be appropriate simply because it was anterior/posterior. That's actually normal. Now if your physician can identify and document work that is above what is normally performed, then modifier -22 could be used. I know that many physicians think that they are going to get paid more simply because modifier -22 is used. Not true. Due to misuse most insurance companies will review the op note to verify that extra work beyond the normal was actually performed and documented.
 
I did query my physician and he said inferior labral tear anterior/posterior not superior so I'm guessing that 29806 is appropriate. So, is 29806 for both anterior & posterior as well? I appreciate your input.
 
Sounds like it from what your doctor said. It's better if the physician documents the "clocking" positions rather than just general "Anterior, Posterior" and so forth. This is true for the sutures and labral tape as well. Code 29806 would cover anterior and posterior but modifier -22 may or may not be appropriate. I would not use it simply because the work was performed in both areas. Modifier -22 is reserved for when work is performed "above and beyond" the normal repair which must be clearly documented. If two separate repairs were performed through separate surgical approaches, or other work beyond the norm, modifier -22 may be appropriate.
 
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Somewhat related to this discussion .... I was told and researched that if both a Bankart (29806) and a SLAP (29807) are done, the 29807 can be reported in addition to the 29806 (with 59) if it's a Type II or Type IV SLAP. Is that correct?
 
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