Help! Shoulder scope and open procedure can it be billed together??

Corona, NY
Best answers
Hello Everyone
I need some clarification on an issue, we have a doctor that states he did a labral debridement and subacromial decompression via scope and then he did a biceps tenodesis as an open. I know that if a procedure starts as a scope and converts to an open we only bill open, however the doctor states its a different procedure and both scope and open can be billed together.
But I have found some sites that state "NCCI edits states "CMS considers the shoulder joint to be a single anatomic structure. An NCCI procedure to procedure edit code pair consisting of two codes describing two shoulder joint procedures should never be bypassed with an NCCI-associated modifier when performed on the ipsilateral shoulder joint. This type of edit may be bypassed only if the two procedures are performed on contralateral joints." Irrespective of arthroscopic or open procedure or both or arthroscopic converted to open, you can only bill for 23410 (Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; acute), as subscapularis, supraspinatus and intraspinatus muscles are of rotator cuff muscles, CPT 23430 for open biceps long tendon tenodesis. You cannot bill 29822 and 29826 in any circumstances, if done on same shoulder - See more at: https://ww
I am very confused as to whether it is correct to bill together or not. the carrier is B.C op report below. I would very much appreciate some guidance. thank you

The arthroscope was introduced into it using a posterior portal. An anterior portal was established. Diagnostic arthroscopy again was carried out. Attention was directed to the cuff debridement. This was done using a 4.2-mm shaver. Care was taken not to violate any normal appearing tissue.

The biceps was now tenotomized for lateral tenodesis.

The labrum was extensively debrided beginning with the superior labrum followed by the posterior labrum followed by the inferior labrum. The supraglenoid tubercle area was explored for possibility of decompressing the paralabral cyst. The arthroscope and instruments were withdrawn and placed into the subacromial space. A lateral portal was established. An extensive bursectomy was performed. The coracoacromial ligament was carefully examined and there was found to be normal. There was a good amount of space in the subacromial space thus a formal acromioplasty was not necessary. The arthroscope and instruments were now withdrawn and the attention was directed to the biceps tenodesis.

A small incision approximately 1.5 cm was made in the axillary crease. This was deepened down through subcutaneous tissue. The pectoral biceps short head interval was exploited, and the underlying long head of the biceps tendon was visualized. Appropriate Hohmann retractors were placed. The biceps tendon was retrieved. An Endobutton was attached using a Krackow stitch. The endoscope was now introduced into the incision where the anterior humeral cortex was well visualized. Using an ArthroCare, the anterior humeral cortex at the site of the biceps tenodesis was cleared off any soft tissues and periosteum. Next, the bur was used to decorticate the bone. The 2-mm drill bit was now used to create a unicortical hole. The Endobutton was inserted into it and deployed and then toggled until the biceps coapted to the anterior humeral cortex quite nicely. The previously placed FiberLink suture was used to shuttle the suture and locked the construct down with 5 reciprocating half hitches. The suture was cut to length. The biceps tenodesis sight was found to be very secure and the arthroscope and instruments were withdrawn. The wound was copiously irrigated and closed in layers using a 2-0 Vicryl and 4-0 Monocryl. The portals were closed using 4-0 Prolene. A dry sterile compressive dressing was applied. The patient was awoken from anesthesia and transferred to the recovery room in stable and satisfactory.