Wiki question about rotator cuff repair

[tmgexp1@yahoo.com]

Patient has commercial coverage. Doc did a repair of the cuff (23412) with acromioplasty. According to guidelines, can I code the acromioplasty (23130-59)? I know that medicare will not pay but was told that some commercial payers will. Thanks for your help

 

[kdsampson]

AAOS guidelines allows 23130 to be billed with rotator cuff repair codes 23410 & 23412. My opinion is to bill it to your commercial carriers, some follow Medicare guidelines, but most have their own set of policies or other guidelines they follow.