Wiki Extensive debridement CPT 29823

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helmaudrey

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Does anyone have any clarification of exactly what is consider discrete structures. If doing a biceps tenodesis, would debriding the bicipital stump be considered a separate discrete structure or when doing a rotator cuff repair would debriding the undersurface of the rotator cuff being considered a discrete structure. All info I could find is that if you are doing a repair on the rotator cuff any debridement of the rotator cuff would not be billed separately and biceps tenodesis, debridement would not be billed separate. Anyone getting denials or being paid when billing the extensive debridement?
 
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helmaudrey said:
Does anyone have any clarification of exactly what is consider discrete structures. If doing a biceps tenodesis, would debriding the bicipital stump be considered a separate discrete structure or when doing a rotator cuff repair would debriding the undersurface of the rotator cuff being considered a discrete structure. All info I could find is that if you are doing a repair on the rotator cuff any debridement of the rotator cuff would not be billed separately and biceps tenodesis, debridement would not be billed separate. Anyone getting denials or being paid when billing the extensive debridement?
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If the provider is performing a biceps tenodesis debriding the stump is included with the tenodesis procedure. The provider has to cut the biceps tendon first before the tenodesis can be performed.
 
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If you search the forums here there are a lot of discussions about this.


You can't separately count the debridement of the stump or debridement of the rotator cuff as part of (29822 or 29823) when it is being done to perform the greater (23430, 29827, 29828) procedure.
Example: RCR, SAD, Biceps tenodesis - you would have to have three additional SEPARATE structures specifically called out and debrided in the op note. So you would not count any debridement done with those three as part of a debridement code. The CPT code descriptions give you examples of the structures and you have to determine according to the op note and what else was done.
  • CPT 29822 — Arthroscopy, shoulder, surgical; debridement, limited, 1 or 2 discrete structures (e.g., humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of the rotator cuff, subacromial bursa, foreign body[ies])
  • CPT 29823 — Arthroscopy, shoulder, surgical; debridement, extensive, 3 or more discrete structures (e.g., humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of the rotator cuff, subacromial bursa, foreign body[ies])
 
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