Wiki Rotator Cuff repair w/allograft patch augmentation

[Dizzylz]

My Dr performed a diagnostic arthroscopy and then performed a open Rotator Cuff revision with allograft patch augmentation and a arthroscopic lysis of adhesions. He wrote the cpt code 29999 which I believe is not correct. I have just about exhausted all reference's I could use for research and can't find anything that would lead me into what code to use...I am hoping that someone can help me with a code that would work for this surgery...thank you in advance..Liz

 

[rlh27]

You can try 23412 with 17999. At first I was thinking 15777 but the notes say For implantation of biologic implants for soft tissue reinforcement in tissues other than breast and trunk, use 17999.

Hope this helps!

 

[Jamie Dezenzo]

take a look at 23420

Per 2005 AMA
23420, Reconstruction of complete shoulder (rotator) cuff avulsion, chronic (includes acromioplasty), is intended to identify an old tear.
This type of extreme tear usually requires rearrangement of the normal anatomy and sometimes grafting with either biological or nonbiological material for repair.

But some carriers may want an unlisted procedure. I do use unlisted for a scope since no "reconstruction"

Jamie

 

[Dizzylz]

Thank you

 

[jason.lang]

After deep research into this, I've discovered that IF arthroscopic the best case scenario and advice is to bill 29999 (Regeneten Path procedure, compare to 23412). 23412 is for OPEN procedure but the lay term describes the procedure to a "T". 17999 wouldn't be appropriate because it's not from the Orthopedic code set.