Wiki Shoulder surgery

[Desperate Denise]

Hey Guys - it is the little shoulder coding chicken!!

The payer is Blue Shieild -

Physician performs arthroscopic rotator cuff repair, excision of distal clavicle including greater than 10 mm, subacromial decompression and debridement of Type 1 superior labral anterior and posterior tear through both the anterior and posterior portals.

The diagnoses includ rotator cuff tear, acromioclavicular joint arthropathy, subacromial impingement and Type I SLAP tear.

I would code 29827, 29826-51, 29824-59 and 29823-59

Can you guys help me - I am not sure if the 29824 is billable but he did bone work greater than 10mm. The second questions is do I use 29823 or 29822 with modifier 59. Because it was both anterior and posterior portals I would conclude that is back and front and use 29823.

What do you think?

Thanks so much!!

Chicken Little aka Desperate D

 

[snbernstein]

Have you checked your NCCI edits for 29822 and 29823?

 

[Desperate Denise]

Shoulder case

nbernstein

I did check the CCI edits and it states that if the physician addresses the tear back to front then I can use 29823. 29822 would be bundled in with 29826 per AAOS - I think.

Any help is appreciated!

Thank you - Denise

 

[BCrandall]

Your codes look right to me. 29824 is for a distal claviculectomy, no matter how much is removed. 29823 is good if the documentation supports it.

Hope that helps!

 

[Desperate Denise]

Shoulder case

Thanks so much for your help Bruce - really appreciate - just a little gun shy these days.

Have a great weekend.

Denise
MWNW Orthopedics