Wiki Surgical Arthroscopy and Open Procedure

[TnRushFan]

Hello folks,

Does anyone know if we still code Surgical Arthroscopic procedures in addition to Open Surgery?
Any thoughts will be appreciated...references will too.
My facility has a new auditor and we have a difference of opinion LOL.

Before I am slammed with "diagnostic scope always bundles into open", I know that if it is the SAME ANATOMIC LOCATION OR STRUCTURE it will bundle or be captured with -22 if supported by documentation.

Arthroscopic Biceps Tenotomy Bundles
Scope Debridement of SLAP Lesion and Subacromial Decompression 29822/29826
Open Clavicle Resection 23120
Open Biceps Tenodesis 23430

Thanks in advance...

 

[cclarson]

It really depends on what's being worked on. If you look at the 2021 NCCI edits, you can see how some open and arthroscopic procedures that are done together are not bundled, while other ones are. Like you can have an Arthroscopic Rotator Cuff Repair with an Open Bicep Tenodesis, both can be coded and reimbursed since it was two separate structures. Also, a diagnostic scope does bundle into open, but it is no longer considered diagnostic if arthroscopic debridement or any other arthroscopic work is done. If you take a look at the NCCI edits, you can see which arthroscopic and open codes can be coded together and which ones bundle. Also, as per the NCCI edits, some arthroscopic debridement procedures can be coded with open procedures with the use of a modifier for a more extensive procedure, though you would definitely need documentation to support it.