Wiki Surgical Billing

[PCMOS]

We billed 29828, 29826, 29824 and 29822. All were paid except 29822 which was denied as being included with other codes. My doctor did an appeal letter, submitted documentation from AAOS but still comes back as denied properly, included with other codes. Anyone have any input if this is now included and the AAOS documentation is incorrect?

 

[michellepilcher]

There is an AAPC article regarding the debridement now being inclusive in the 2017 NCCI update.


Subsection 7 provides the three exceptions:

Shoulder arthroscopy procedures include limited debridement (e.g., CPT code 29822) even if the limited debridement is performed in a different area of the same shoulder than the other procedure. 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. CPT codes 29824 (arthroscopic claviculectomy including distal articular surface), 29827 (arthroscopic rotator cuff repair), and 29828 (biceps tenodesis) may be reported separately with CPT code 29823 if the extensive debridement is performed in a different area of the same shoulder.

https://www.aapc.com/blog/37359-the...s-to-shoulder-arthroscopy-in-the-ncci-manual/