Results 1 to 4 of 4

Open Claviculectomy

  1. #1
    Default Open Claviculectomy
    Medical Coding Books
    Can anyone give me some advice on this one?

    Operation Performed: Right AC Joint excision arthroplasty and acromioplasty

    In view of the failure of conservative measures to control his pain, it was elected to decompress the tendons and remove the distal end of the clavicle. He was placed in beach chair position, incision was made over the AC joint and extended this over the anterior aspect of the acromion. Dissection was carried down thru subcut tissues. I then exposed the distal end of the clavicle subperiosteally with sharp dissection and then using the mini Homann retractors exposed the AC joint and then using a small oscillating saw resected the distal 1 cm of clavicle. There were large osteophytes and the superior and inferior surface of the clavicle fragment. This was sent for path. I then used the rasp and contoured the under surface of the end of the clavicle that was remaining and also the acromial side of the AC joint. I then dissected further lateral and then split deltoid anteriorly. Approach to the subacromial space from the lateral portion of the bursa was grossly thickened. This was excised with sharp dissection. The underlying rotator cuff was inspected and were intact. I then proceeded to resect the spur off the anterior acromion using a small osteostomes and a rasp. After the decompression at the subacromial space, the wound was then irrigated and closed...."

    I can see where the 23130 was done, but I also see the 23120. I do the facility side and the doc chose only the 23130 for his side. Am I missing something or am I overcoding? Can't I code both and should I? I don't see anywhere in the CCI edits that I can't code them together. Is it because one is incidental to the other? It seems to me that they are in two different compartments of the shoulder (ie AC joint and subacromial space) and therefore are seperately reportable. Can anyone please help to explain what it is that I am missing?

  2. #2
    AAOS guidelines state that distal clavicle excision is not included in 23130 but needs to be over 1.0cm. AMA CPT Assistant gives no guidance that I can find.

  3. #3
    Does it have to be over 1cm or can it be 1cm or over?

  4. #4
    The way it reads in the 2009 AAOS GSD is "distal clavicle excision over 1.0 cm (for eg, 23120)". I can't find any additional info from the AMA or CMS. I've seen information on Mumford's that give guidelines anywhere from 8mm and up, but generally falling in the 10mm or greater range. If your carrier isn't using AAOS guidelines it seems as though you could bill both codes. Anyone else have additional information on this?

Similar Threads

  1. subacromial decompression/open claviculectomy
    By nabernhardt in forum Orthopaedics
    Replies: 4
    Last Post: 08-07-2012, 11:23 AM
  2. claviculectomy
    By ccarroll in forum Orthopaedics
    Replies: 4
    Last Post: 04-09-2012, 07:47 AM
  3. 29826 changes with open claviculectomy
    By hencked in forum Orthopaedics
    Replies: 2
    Last Post: 01-16-2012, 09:02 AM
  4. lap claviculectomy
    By BCushing in forum Orthopaedics
    Replies: 1
    Last Post: 02-06-2009, 01:23 PM
  5. Replies: 1
    Last Post: 11-10-2008, 12:46 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.