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Thread: Shoulder Arthroscopy Question

  1. #1

    Default Shoulder Arthroscopy Question

    Our physician performed a shoulder arthroscopy, posterior inferior labral repair, and anterior inferior capsular shift. How would these be coded? We would use 29806 for the inferior labrum repair but since the capsulorrhaphy is the same code, what would we use for the labrum repair? I am finding contradicting answers to this question. Some say to use 29806 & 29807 because the physician performed two procedures, but I have a hard time understanding that because the 29807 is clearly for the superior labrum. I would appreciate any input on this. Thank you.

  2. #2
    Join Date
    Apr 2007
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    Bangor, Maine
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    719

    Default

    Per AAOS August 2003-"You can report 29806 with 29807ONLY if the SLAP lesion repair is Type 2 or Type 4. For the other 5 types of SLAP lesions, it may not be appropriate to report 29807 with 29806." It also states that the surgeon needs to be clear in their op notes of the types of SLAP lesions being repaired. They also need to be clear that 2 seperate lesions are being operated on: SLAP lesions and a capsular defect. If he did do both than you can report them with a -59 modifier. 29807 means that the technique used was that the suture was brought up through the capsule. That means that the suture has to go through the capsule to get to the bone, and that does not neccessarily mean that a capsulorrhaphy was done. I am not sure if this helps or makes it more confusing for you. Hopefully, it was helpful but definitely try the AAOS bulletins for info, though. They have a lot of info and Q&A.

  3. #3

    Default

    Thanks for the response! This was not a SLAP lesion though because the surgeon dictates that the INFERIOR labrum was repaired and a SLAP is the SUPERIOR labrum. I know that he did the capsulorrhaphy based on his dictation, and he clearly does two separate procedures, I am still unsure how to code the labral repair! I will check the AAOS bulletins, definitely!

  4. #4
    Join Date
    Apr 2007
    Location
    Bangor, Maine
    Posts
    719

    Default late info

    I know this is a little late but I read something today and it reminded me of your question so I just wanted to share. This will also help me to remember this situation if it ever comes up to me again. Outpatient Surgery Weekly quotes " Simply because a labrum is torn and repaired, it doesn't automatically warrent reporting 29807 if the torn labrum isn't a SLAP tear. CPT 29807 is SPECIFICALLY for SLAP repairs, don't use it for labrum tears that are not SLAP. A coder shouldn't confuse a surgeon's repair of the labrum by by attaching it to the capsule as a seperately identifiable capsulorrhaphy. The seperate reporting of the capsulorrhaphy is indicated when there is a capsular defect unrelated to the labrum tear that in itself also warrents repair." Again, I know this is too little too late but I just thought I would try to let you know in case it ever comes up again. Have a great day!!

  5. #5
    Join Date
    Apr 2007
    Posts
    90

    Default so if it is a labral tear

    but not a SLAP tear, what is the diagnosis ICD-9 code that you use? Can you only use
    840.7 with with an actual Superior labrum anterior to posterior tear, or can you use it for any tear of the labrum, but code the CPT code accordingly? Docs tend to call everything a SLAP tear and I always get hung up on the ICD-9 code.

  6. #6
    Join Date
    Apr 2007
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    ENGLEWOOD/DENVER
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    Default

    718.01 or 726.10 are options

  7. #7

    Default Still don't know...

    We always use 726.2 for a labral tear that is not a SLAP. So I know not to use 29807 for this surgery b/c it isn't a true SLAP tear, but what code would I use then? Only the 29806 for the work performed on the capsule?

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