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Thread: Opinions On How You Would Code This

  1. #1

    Question Opinions On How You Would Code This

    AAPC: Back to School
    1. Left shoulder arthroscopy w/ arthroscopic subacromial decompression.
    2. Arthroscopic distal clavicle excision. (29824)
    3. Arthroscopic biceps tenolysis. (?)
    4. Arthroscopic humeral head chondroplasty. (?)
    5. Extensive glenohumeral synovectomy. (?)

    Through the anterior portal, biceps tendon was released w/ a cautery device, allowing it to retract out of the shoulder. No attempt at tenodesis was performed. The superior and anterior labral edges were then debrided w/ the 4.5 full-radius shaver and the 90 degree vapr wand to a smooth edge. These were reprobed and found to be completely stable. The 4.5 full radius shaver was then used to perform a gentle chondroplasty on the humeral head at the edges where the cartilage was mildly frayed. The humeral head was rotated to accomplish this. At that point, a fairly extensive synovectomy was performed initially posteriorly, but then superiorly, and then anteriorly. This was accomplished w/ a combination of 4.5 full radius shaver and 90 degree vapr wand. Most, but not all of the synovium was removed in this fashion. No attempt was performed in the axillary pouch.
    The scope then switched into the subacromial space and a lateral portal created. A significant bursectomy was performed initially for visualization and then to remove this structure since it was fairly thickened and there was evidence of this as the source of impingement and crepitus. Once removed, the superior surface of the cuff was found to be intact. The anterolateral spur was then removed w/ an acrominizer bur, opening up the space nicely. The medial ridge was then taken back to the AC joint where the distal clavicle was resected. Initially, this was done utilizing a co planning type maneuver on the undersurface, but then through the anterior portal the distal clavicle itself was excised. Small amount of the acromion was removed in this fashion as well. At that point, all extra fluid was drained and any debris removed.



  2. #2
    Join Date
    Apr 2007


    29826 (SAD) (documentation stinks)
    29823 (debridement of labrum/chondroplasty/synovectomy)
    29824-59 (DCE)
    maybe 29999 (Biceps) (this documentation stinks)

    Mary, CPC,COSC

  3. #3


    Yeah the documentation does stink. LOL...
    What procedure code for the fee would you go off of for the unlisted procedure? Since I'm assuming the insurance will probably request documentation for that.
    Thanks for your help!! I appreciate it.

  4. #4
    Join Date
    Apr 2007


    23405 is the cross code I would use

  5. #5


    Ok, thanks for all your help.

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