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RTC Repair w/ Tissue Graft

  1. #1
    Question RTC Repair w/ Tissue Graft
    Medical Coding Books
    I have a physician who is performing a RTC Repair with a tissue graft. The "Double Syringe System" is used to prepare the graft and then is injected into the tear site. This is done arthroscopically.

    My question is would you still use 29827 for the repair or use an unlisted code?

    Any input would be helpful!

  2. #2
    South Bend
    Double Syringe System......Is this a GPS where they use platelets?

    There are a lot of coverage guidelines for those type of systems. The GPS from Biomet does look like a double syringe that's what made me think of that.

  3. #3
    I know there is an unlisted code to use for the PRP injection (86999) but I am not sure if I should use 29827 for the repair if it was performed by application of tissue graft.

  4. #4
    can you post the desensitized op note for this case?
    Mary, CPC, CANPC, COSC

  5. #5
    Here is the portion of the RTC procedure.....

    "...The undersurface of the rotator cuff was examined. It was noted to be a tear of the supraspinatus tendon beginning at the rotator cuff interval and extending into a posterior directions towards the infraspinatus. The tear was 1.5-2 cm in length and was at the greater tuberosity insertion. A debridement of the tear was performed utilizing a motorized shaver. The torn tendon was debrided and removed. Heathy tendon fibers were uncovered during a debridement. A motorized bur was inserted into the shoulder and the greater tuberosity was prepared with the bur by removing the remaining fibers of the already debrided tendon from the bone and removing a portion of the subchondral bone in order to expose the tear to a bleeding bone surface.....

    (Subacromial Decompression and Distal Clavicle resection were performed)

    ...Next, a tissue graft was applied into the zone of injury at the supraspinatus. The Arthrex ACP Double Syringe System was used to prepare the graft. A total of 9 ml of blood was taken from the patient. This was placed into the Double Syringe and was placed into the Arthrex Centrifuge and spun for 5 minutes at 1500rpm. From the inner syringe 5ml of platelet rich plasma was extracted. This constituted the tissue graft and was injected at the tear site. A spinal needle was directed into the tear site under direct arthroscopic visualization. The growth factors were injected following the removal of saline from the joint."

  6. #6
    I would still use the 29827 for the repair. The PRP procedure will be inclusive of the 29827 per Margie Vaughts article. If you go to on the left hand side of the page, look for PRP and she has had several inquiries with CPT and AMA regarding this.
    Mary, CPC, CANPC, COSC

  7. #7
    Thanks so much for your input!

  8. Default
    What is HCPCS P9020 used for with PRP?

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