This IS a first for me - - - "arthroscopic SAD with percutaneous fixation of greater tuberosity fragment"Not sure if I need to look to unlisted scope (29999) or code as open ORIF Greater tuberosity and add -52 for reduced services (23630-52) or unlisted "open" for shoulder (23929) - not even sure what to compare the unlisted codes to at this point as there is not a percutaneous code for this.
Report reads: ".......prepped and draped in normal sterile fashion. Next, utilizing a #11 blade scalpel, a small incision was made posteriorly for the posterior portal. Diagnostic arthroscopy in the glenohumeral joint commenced. After diagnostic arthroscopy in the glenohumeral joint, I then placed the arthroscope into the SA space. There was some bursitis and bleeding in that area. Therefore, I created a lateral portal and a bursectomy was done with meniscotome. I identified the fracture fragment with spinal needles both anterior and posterior to the fracture fragment region, both intra-articularly and in the SA space. This gave me good location for the starting point of the cannulated screws. Next, under fluoroscopic imaging, two 4.0mm partially threaded cannulated screws were placed in the greater tuberosity fragment with some compression noted bringing the fracture back down towards more normal anatomic position. The arthroscopic equipment was removed. Fluoro imaging was taken. AP & axillary views did show good placement of screws with improvement of alignment and anatomic position of fracture fragment. Incisions were closed with nylon.