shoulder debridements

Jamie Dezenzo

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Hello all,


Example #1

29827 and 29826 done but states

"entire intraarticular aspect of the joint was quite indurated and inflamed and the intraarticular aspect of the joint debrided with the Stryker shaver to just debride some of the inflamed synovium...Then goes into subacromial space for 29826/and 29827"

Did not indicate in pre/post dx or procedure performed....bill 29822 rather 29820 727.00?

Example #2

Coding 29806 and 29826 but states "Extensive capsulitis and synovitis debrided"....
Enough to bill 29823?

Thanks!
Jamie
 

PLAIDMAN

True Blue
Messages
520
Best answers
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Hello all,


Example #1

29827 and 29826 done but states

"entire intraarticular aspect of the joint was quite indurated and inflamed and the intraarticular aspect of the joint debrided with the Stryker shaver to just debride some of the inflamed synovium...Then goes into subacromial space for 29826/and 29827"

Did not indicate in pre/post dx or procedure performed....bill 29822 rather 29820 727.00?

Example #2

Coding 29806 and 29826 but states "Extensive capsulitis and synovitis debrided"....
Enough to bill 29823?

Thanks!
Jamie
Some commercial payors will pay for intra articular debridement if done in separate "area" than other procedures (medicare does not recognize separate "areas" of shoulder) the synovectomy is included in 29827, so I would not bill that. Your payor may find the both 29820 or 29822 incidental as no pre/post dx and no indication that it impoved function?What was medical necessity? Synovial resection for visualization is always included.


I follow AAOS guidelines for 29823, which advises should be used only for extensive debridement, typically both hard and soft tissues, I would use 29823 when doc did chondroplasty of humeral head and glenoid as well as debridement of labrum. Based on documenation provided for #2, I would not bill 29823.

hope that helps a little bit
 
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