AAPC - Back to school
Results 1 to 2 of 2

Thread: Arthroscopic Rotator Cuff Tear Repair...

  1. #1

    Default Arthroscopic Rotator Cuff Tear Repair...

    AAPC: Back to School
    CPTs 29826, 29827, 29828, 20610...? no bundling issues?

    1. Full thickness rotator cuff tear repair with metallic suture anchors, double-loaded suture
    2. Partial acromionectomy
    3. Biceps tenodesis
    4. Resection partial-thickness, superior-surface, subcapularis tendon repair

    After the anatomy was drawon onto the skin, a posterior portal site was made after going 2 cm distal, 1 cm medial from the posterolateral acromion. A stab wound was subsequently made and the trocar subsequently placed through the stab wound into the acromial space. The arthroscope was introduced, and the subacromial space was insufflated with normal saline. After thorough observation, the anterolateral portal was made 2 cm distal to the anterolateral edge of the acromion. The exact location was located with an 18-gauge spinal needle and was seen intra-articularly. A stab wound was subsequently made in the skin, and a blunt trocar was placed to establish a working portal site. Hemostasis was obtained with electrocautery within the subacromial space throughout the case.

    The Arthrotec electrocautery wand was introduced, and the underlying soft tissues on the undersurface of the acromion was resected. Pictures were taken of the subacromial impingement. The Acromionizer was subsequently used to debride the bony undersurface of the acromion in a tapered fashion in the usual manner. It appeared that an appropriate amount of bone was removed, and the AC joint was not entered. Attempts were made to obtain pictures. The subacromial space was thoroughly irrigated, and all fluid that could be removed was remoevd.

    Through the posterior portal, because of the large size of the massive rotator cuff tear, teh edges of the rotator cuff were freshened. Soft tissues were debrided off of the greater tuberosity. With the use of an ArthroWand and 4.5 full radius resector, the long head of the biceps tendon that was torn was resected free. The superior surface of the subscapularis tendon where the partial tear was located was resected. Two metallic, double-loaded suture anchors with #2 MaxBraid blue & white were inserted to allow for side-to-side repair of the tendon as well as pulling back down to the greater tuberosity with excellent reapposition of the bony footprint. The scope was then inserted through the posterior portal into the glenohumeral joint. The joint was insufflated with normal saline. The rotator cuff footprint was noted to be reestablish nicely.

    An 18-gauge spinal needle was insered into the subacromial space. A steroid Marcaine cocktail was injected. The skin edges were re-apposed with simple interrupted 3-0 nylon suture. A sterile Adaptic and bukly gauze dressing was applied and secured with foam tape. The patient was extubated, transferred to the bed and taken to the recovery room. The patient appeared to tolerate the procedure well without apparent complications.

  2. #2
    Join Date
    Apr 2007


    I agree with all except the 20610, even though it shows allowed via CCI edits, which I cant for the life of me tell you why since MCR has the strict guidelines that injections are part of the global surgical package. I also think, not positive because I dont actually have the guide, but the AAOS global surgery book may also show that this is inclusive of the surgery.

    hope this helps

    actually..now that I just re-read the note...where is the biceps tenodesis reported? I see a resection of the biceps, but I dont see anything else....did I miss it?
    Last edited by mbort; 08-20-2009 at 10:46 AM.
    Mary, CPC, CANPC, COSC

Similar Threads

  1. Billing for Arthroscopic repair of Rotator cuff
    By Razia Asghar in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 02-04-2015, 09:21 AM
  2. Arthroscopic rotator cuff repair question
    By dollyleaf5 in forum Outpatient Facilities
    Replies: 2
    Last Post: 08-11-2010, 12:31 PM
  3. massive rotator cuff tear, partial repair
    By Alta in forum Orthopaedics
    Replies: 0
    Last Post: 04-19-2010, 09:20 AM
  4. open repair rotator cuff tear
    By Trendale in forum Orthopaedics
    Replies: 2
    Last Post: 08-13-2009, 06:30 PM
  5. Arthroscopic Rotator Cuff Repair x2
    By luckystoner13 in forum Orthopaedics
    Replies: 2
    Last Post: 03-05-2009, 01:52 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.