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help Ortho Experts!

dmaec

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ok ortho experts - without posting the entire 3 page op report - just going by the listed procedure performed:

PROCEDURE: Left shoulder arthroscopy and debridement with open subacromial decompression and distal clavicle excision, biceps tenodesis, and a Bankart reconstruction

what CPT(s) do you come up with? I come up with 4 different CPT's - and the use of a modifier. I'd like to know just how far off base I am on this! LOL

anybody care to offer their opinion ?

thanks MUCH!
 

mbort

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Donna thats a tough one without a note..but here goes.

29822 vs 29823 (may bundle depending on documentation and what/how much they are debriding)
23130 vs 23415 subacromial decompression (depending on documentation)
23120 distal clavicle
23430 biceps tenodesis
23455 vs 23450 Bankart (again dependent on documentation)

Hope this helps and doesnt hinder what you already have :)
Mary
 

dmaec

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thanks Mary for responding !!- here's what I came up with (close to yours but not quite the same - I realize you were flying blind on this without the note) anyway - I came up with:
29806 (shoulder arthroscopy)
29823.59 (debridement)
23430 (biceps tenodesis)
23120 (distal clavical)

I didn't code the Bankart because when I looked it up it said to use 29806 if arthroscopic procedure....???

ok, so tell me how come you didn't use the 29806? what did I miss? (in that basic procedure line)...or did I read too much into it??

and I see I totally missed coding out the decompression (23130/23415)depending ....
 
Last edited:

dmaec

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But wouldn't you still code the Left shoulder arthroscopy code 29806 (and debridement)...then the rest as they are? (open)...
 

mbort

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In order to capture the 29806, the Bankhart must be documented being done through the scope. The only thing I see in the title of the original post that was done through the scope was the debridement therefore the 29822/29823 would be the only scope codes and then it appears he converted to open to do the rest of the procedures. Its possible that the 29822/29823 will bundle so you may not be able to use any scope codes at all and have to use the V code for the "convert to open" as well.
 

dmaec

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thanks Mary - that it explains it very well!! I get it now. I've noticed (and I just started doing this docs ortho procedures), he "always" states "shoulder arthroscopy and debridement" with ----and goes on to list other things he does. I kept wanting to code the 29806, even though he converts to open for the other procedures. I wonder why he states it that way, it makes me want to code it! ;)

Thanks again for your help - you've cleared my headache up!
 
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