Mumford procedure CPT 29824

pochranek

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I have a denial stating cpt 29824 needs to indicate the size of the removal of the distal clavicle.

I cannot find where it is documented this is needed - my physician wants to know where it is written he has to document the size of the removal.

Do anyone have any suggestions where i can find this information?

Thanks for your help!
 

scooter1

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In my Ingenix Coding Companion for CPT 29824 it states:

To qualify for reimbursement of distal claviculectomy, documentation should support removal of 8-10 mm from the distal clavicle/joint.
 

scooter1

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Also this from AAPC :




Home > News & Press > Don't Choose Shoulder Scope Codes Off the CuffDon't Choose Shoulder Scope Codes Off the Cuff
March 26th, 2009

Rotator Cuff Repair and Reconstruction
When it comes to rotator cuff repairs, pay close attention to wording, or lack there of. CPT® rotator cuff Repair, Revision, and/or Reconstruction codes 23410 Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; acute, 23412 Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; chronic, and 23420 Reconstruction of complete shoulder (rotator) cuff avulsion, chronic (includes acromioplasty) are for acute or chronic conditions only. If you don't see “acute” or “chronic” in the documentation, “don't assume,” says Christina Bentin, CCS-P, CPC-H, CMA, in her article “Getting Reimbursed for Shoulder Scopes” (registration required). The condition must be documented to support the code selection.

Distal Claviculectomy
Excision of the distal clavicle involving more than a simple shaving of osteophytes at the AC joint is reported separately whether performed open or closed, according to the American Academy of Orthopaedic Surgeons (AAOS). The operative report must indicate the distal clavicle excision size to separately report CPT® codes 23120 Claviculectomy; partial and 29824 Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (Mumford procedure).

Note that some carriers may consider an excision of less than 1 cm inclusive to the main procedure, so always check your carrier's policy before reporting these codes separately
 
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