New with Ortho...Help!

pmogel

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Glendale, AZ
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Need help / advice with this surgery. I know 29826 is an add-on code and will be one of my choices, but I'm a little lost on the primary CPT. None of them really describe what was done (29805-29825, 29827,29828). Here's how the report reads:

PREOPERATIVE DIAGNOSES:
l. Right shoulder impingement syndrome.
2. Nondisplaced Bankart lesion.

POSTOPERATIVE DIAGNOSES:
1. Impingement syndrome.
2. Rejectively healed Bankart lesion.

OPERATIONS PERFORMED:
1. Surgical arthroscopy, right shoulder.
2. Acromioplasty with coracoacromialligament resection.

ANESTHESIA: General plus interscalene block.

ESTIMATED BLOOD LOSS: Minimal.

DESCRIPTION OF PROCEDURE: The patient was taken back to the operating room, placed
on the operating table in a supine position, and was given a general anesthesia after an
interscalene block had been applied by Dr. ***** in the holding area. The patient was placed in the beach-chair position. The right shoulder was evaluated and noted to have some anterior posterior subluxation noted. The shoulder was sterilely prepped and draped in the usual orthopedic fashion. A standard posterior approach was made with the knife and a blunt trocar. A diagnostic arthroscopy was carried out. Evaluation of the joint showed the rotator cuff to be well attached. The biceps was well attached The labrum was well attached. The anterior area in question with the MRI showed a 1-mm linear separation between the anterior labrum and the glenoid lbis was not a significant-appearing Bankart lesion and that was unstable. This lesion was nondisplaced and healing in the appropriate position and with no instability whatsoever on the cartilage rim. Therefore, it was decided to leave this area alone and allow it to continue to heal. Of note was abundance in the capsule inferiorly and superiorly and so much anteriorly. The joint was thoroughly irrigated. The subacromial space was then entered, and an accessory lateral portal was established. A bursectomy was completed. This revealed the underlying impingement from the anterior acromion and had type 2 acromion that was impacting the rotator cuff with forward elevation. This area underwent an acromioplasty with CA ligament resection. This gave an excellent relief of the impingement. The joint was thoroughly irrigated. The fluid was allowed to drain. The portals were closed with 3-0 nylon vertical mattress suture. The incisions were dressed with Adaptic, 4x4's, ABDs, and tape.

I can't append 29826 to 29805, even tho it is clear he did a diagnostic arthroscopy. Any suggestions?

Thank you!!!!!
:confused:
 
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