Wiki Failed Rotator Cuff Repair - out of Global period.


Dayton, PA
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Can anyone tell me how to code a failed rotator cuff repair - out of Global Period?

I am looking under complications but not sure if I go under postprocedural or surgical procedure, going under prosthetic device does not seem right to me. Can some one please help me.

Thank you,
In trying to help you I am assuming the patient in question had a Non-traumatic Complete Rotator Cuff Tear (M75.12 _) repaired in the past (beyond the 90 day Global time frame). Now the patient has a failed repair and a "Recurrent" Chronic Rotator Cuff Tear, and I am assuming there has been no trauma associated with the current retear/failure situation. So the patient now has M75.12 _ all over again. Without a history of "trauma," this "could" be considered a Spontaneous Rupture of Other Tendon (Repaired Rotator Cuff), i.e. a non-traumatic rupture of the (repaired) tendon at the musculotendonous junction/insertion: M66.81 _. This Code Set does not appear to Exclude the Rotator Cuff.
Also, there is T81.32X _: (Deep) Disruption of Internal operation/surgical wound, which includes the "dehiscence" of the closure/repair of a tendon.

Since this is outside the Global Period, you could probably use all three. I would probably sequence them as M75.12 _, T81.32X _, then M66.81 _. That would essentially "tell the story" of the situation. Others may think differently, and I would like to see what others say.

Respectfully submitted, Alan Pechacek, M.D.