Wiki shoulder fracture question

[desertsteph65]

the ortho I work for stated in a op report that he did an orif of the shoulder with a glenoid lag screw. he also did a orif of the scapula with internal fixation. He claims this is two different procedures but I coded 23585 as it included scapular and glenoid.

Any ideas?? Is he not being specific enough or am I not reading it right?
thanks

 

[SRawstron]

shoulder ?2 codes vs 1 procedure

This may very well be 2 procedures as the doc indicates, but not necessarily 2 CPT codes. If your code identifies both procedures he did, perhaps he needs to understand those procedures are bundled codes. Of note, he certainly may have anticipated only having to do one procedure, then got in there and found more repair was necessary. Thus, 2 procedures, but one code identifies more work. Check for supportive documentation and the probability of a modifier, which reflects the extra work.

 

[desertsteph65]

Thank you so much for your help. He decided it was one code with a 22 modifier.