I cannot seem to square what I see as a contradiction in the NCCI edits with respect to shoulder arthroscopy. According to the change in the policy manual in 2017, “With three exceptions, shoulder arthroscopy procedures include extensive debridement (e.g., CPT code 29823) even if the extensive debridement is performed in a different area of the same shoulder than the other procedure.” Those three exceptions are 29824, 29827, and 29828. But the exception is only valid if the debridement is done in a separate area of the shoulder from where those procedures were done. Outside of those three exceptions, according to what appears to be the plain language of the manual, if any other shoulder procedure is done along with 29823 than the debridement bundles into the other code. Therefore, based on this it sure seems that if 29821 and 29823 are performed on the same shoulder than 29823 bundles into 29821. Alas, the NCCI PTP spreadsheet tells a different story. In the latest version of the PTP edits spreadsheet, 29823 is the column 1 code and 29821 is the column 2 code, and the rationale is “More extensive procedure”. So, which is it? Does 29823 always bundle as the policy manual says (except for the three exceptions) or does 29821 and the other column 2 codes bundle into 29823? What am I missing?