Remplissage Procedure

[yvetteprater]

Looking for anyone who is familiar with the coding of this procedure. We have tried different codes. We do use unlisted code 29999. Some articles I have read state to use CPT code 29827. Others state, if doing the procedure with 29806, add the modifier 22. Any feedback would be much appreciated.

 

[amyjph]

This is an old link but still true: https://www.aapc.com/blog/39114-stay-current-when-reporting-shoulder-procedures/

Remplissage (meaning “to fill in”) is becoming more common for a posterior Hill-Sachs lesion following an anterior dislocation. The surgeon fills in the lesion by capsulodesis and a tenodesis of the infraspinatus. The remplissage is considered inclusive to the Bankhart, according to the AAOS; however, American Hospital Association’s (AHA) Coding Clinic for HCPCS (third quarter, 2016) advises reporting both the capsulorrhaphy (29806) and an unlisted arthroscopy code (29999) for the remplissage procedure. This will come down to payer policy.

I haven't checked CPT Asst. or Coding Clinic lately but you should check there and with the payer first.

In my opinion it's a technique used as part of the Bankart if done during 29806. If documented well and the 22 is justified, you would append modifier 22 to 29806. Prepare for a records request, possibly delayed payment, and be sure to verify the reimbusement for the 22. I doubt you would ever see additional payment for reporting 29999 especially if you attempted to code it along with 29806.

 

[jovibon110@gmail.com]

We Had Karen Zupko and Associates do an Ortho seminar at the Hospital I work for last July and they said 29806 w/ mod 22