Help! Shoulder Surgery Mini Open twice?


Rineyville, KY
Best answers
Arthroscopic Subacromial Decompression 29826
Arthroscopic Distal Claviculectomy 29824
Mini Open Subscapularis tendon Repair 23412
Separate Incision Mini Open Supraspinatus and Infraspinatus Repair?
*Dr wants to bill Mini open twice??:confused:

Mini open incision was made over the lateral portal for the supraspinatus and infraspinatus repair. The tendon was mobilized and eventually five anchors were placed from posterior to anterior with double limbed Fiberwire in a standard fashion, Arthrex corkscrews. Sutures were passed with alternating simple and horizontal mattress suture fashion using a Scorpion needle from posteiro to anterior and tied down and incorporated into four push-lock repairs, double row repair and using a cross-bridge technique. A very stout rotator cuff repair was achieved. The biceps tendon was noted to be in its groove, and then this wound was closed with two figure-of-eight 0 vicryl in the deltoid after copious irrigation, deep fat 0 vicryl and the skin was closed with Nylons, including the posterolateral portal. A 5 cm incision was made in the deltopectoral groove at the level of the subscapularis insertion. Dissection was carried down to the deltopectoral groove and retractors were placed and deep retractors were placed and a subscapularis tendon was mobilized beneath the coracobrachialis fascia and mobilized and two 6.5 anchors were placed just medial to the bicipital groove and the sutures were passed with Scorpion needle and simple fashion and they were tied down from the superior to inferior and incorporated into double row repair with push-lock. A stout repair of the suprascapularis tendon was achived, as well. The wound was copiously irrigated. The deltopectoral groove was closed with two figure-of-eight 0 vicryl sutures, deep fat 0 vicryl and the skin was closed with Nylon. The incisions were all washed and dried and sterile dressings applied. The patient was placed in abduction pillow and sling. He tolerated the procedure well, was extubated and taken to the recovery room.

Would 23412 once take care of both incisions and all the repairs? What would you bill to capure all the work?:eek:

Thank you for all your help!


Best answers
Take a look at what CPT Assistant 2008 for 29827 has to say regarding arthroscopic repair.

Essentially, it says that for the arthroscopic procedure it doesn't matter if additional portals are used to repair different tendons. 29827 represents the repair of one, two or three tendons.

I'm not sure, but that may translate over to open procedures as well. Its a starting point.