Wiki Open Cuff Repairs with Acromioplasty

[talitha82]

Often times my surgeon will do an open cuff repair with a clavicle excision and an acromioplasty. I used to code these with the appropriate open code and then 29824 and 29823 (because the clavicle and acromio are done arthroscopically usually.)

I would use 29823 in place of 29826, because you can't bill 29826 with open repairs. However, as of last year, I understand you can no longer bill out 29823 with other arthroscopic procedures like 29824, because they are considered inclusive. (I think they've been considered inclusive for a while, but you used to be able to break them out if debridement was done in another compartment of the shoulder.)

So my question is, if this is the case, can I no longer bill out the 29823 for the acromioplasty, and only bill the open code for cuff repair along with 29824 for the clavicle? What would I code for the acromioplasty? I hope that makes sense.

Are there any shoulder experts out there who can help me?

 

[talitha82]

No takers?

I'm still really curious about this...does anyone have any ideas?

 

[Jennae929]

Did you ever find an answer to this question? I am running into this same problem and it's driving me crazy trying to find a firm answer. My other question is: If my Physician documents that he did a Rotator Cuff repair (23420) which includes the acromioplasty and then also documents that he did an acrominectomy and/or a coracoacromial ligament release would it be appropriate to bill a 23130 along with the 23420?

 

[MELJNBBRB]

I found these, I am still mastering Ortho myself lol but thought maybe these may help.

M,CCS,CPC




Partial acromioplasty or acromionectomy with or without coracoacromial ligament release

CPT Assistant, February 2015 Page: 10 Category: Frequently Asked Questions

Related Information


Frequently Asked Questions: Surgery: Musculoskeletal System



Question:



Does code 23412, Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; chronic, include a partial acromioplasty or acromionectomy with or without coracoacromial ligament release?



Answer:



No. Code 23412 does not include a partial acromioplasty or acromionectomy with or without coracoacromial ligament release. To report such a procedure, use code 23130.












Acromionectomy with rotator cuff repair

CPT Assistant, August 2001 Page: 11 Category: Coding Consultation

Related Information
Musculoskeletal System



Question



When reporting an acute rotator cuff repair, should the partial acromionectomy be reported separately with code 23130, Acromioplasty or acromionectomy, partial, with or without coracoacromial ligament release?



AMA Comment



From a coding perspective, code 23410, Repair of musculotendinous cuff (eg, rotator cuff); acute, includes the work involved in performing a partial acromionectomy. Therefore, it would not be appropriate to report 23130 separately.

 

[talitha82]

I found these, I am still mastering Ortho myself lol but thought maybe these may help.

M,CCS,CPC




Partial acromioplasty or acromionectomy with or without coracoacromial ligament release

CPT Assistant, February 2015 Page: 10 Category: Frequently Asked Questions

Related Information


Frequently Asked Questions: Surgery: Musculoskeletal System



Question:



Does code 23412, Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; chronic, include a partial acromioplasty or acromionectomy with or without coracoacromial ligament release?



Answer:



No. Code 23412 does not include a partial acromioplasty or acromionectomy with or without coracoacromial ligament release. To report such a procedure, use code 23130.












Acromionectomy with rotator cuff repair

CPT Assistant, August 2001 Page: 11 Category: Coding Consultation

Related Information
Musculoskeletal System



Question



When reporting an acute rotator cuff repair, should the partial acromionectomy be reported separately with code 23130, Acromioplasty or acromionectomy, partial, with or without coracoacromial ligament release?



AMA Comment



From a coding perspective, code 23410, Repair of musculotendinous cuff (eg, rotator cuff); acute, includes the work involved in performing a partial acromionectomy. Therefore, it would not be appropriate to report 23130 separately.

Thanks for the information! I would not be able to code a 23130 however because the acromioplasty was done arthroscopically, and then the cuff repair was converted to open. So I am wondering how to code these now that the debridement codes are not allowed with other arthro codes, such as 29824 (since in the past, an arthro acromio would have been coded with the 29822-29823 but now those are not allowed to be coded with a 29824...) if that all makes sense?

 

[talitha82]

Did you ever find an answer to this question? I am running into this same problem and it's driving me crazy trying to find a firm answer. My other question is: If my Physician documents that he did a Rotator Cuff repair (23420) which includes the acromioplasty and then also documents that he did an acrominectomy and/or a coracoacromial ligament release would it be appropriate to bill a 23130 along with the 23420?

Was the acrominectomy and/or coracoacromial ligament open? If so, I don't think there are any CCI edits for 23420 and 23130. You should double check before coding, but I just looked and I don't see any edits coming up for these two codes. So you should be fine.