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can 29806 & 29826 be billed

  1. Default can 29806 & 29826 be billed
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    I have op report which states impingement on shoulder & anterior inferior instability. Dr is doing closure of the subscapularis rotator cuff interval & subacromial decompression but I know according to CCI edits these two are bundled so I'm not sure if AAOS says any different & are they any special circumstances when & if it can be billed together?

  2. #2
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    Were seperate incisions made for each procedure?

  3. #3
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    I just looked in the AAOS Complete Global Service Data books, and according to them 29826 is not included in 29806 and can be billed seperately. Hope this helps!

    Richard

  4. Default
    no separate incisions were made, the arthroscope was just redirected into the subacromial space-------& yes, I do have that information from the complete data service book AAOS but even though its stated as not bundled i still don't know under what circumstances can it be unbundled?

  5. #5
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    Its been my understanding that if the procedure was performed in a different compartment it is coded and charged, much like the knee. If a procedure in one compartment is performed and a chondroplasty is performed in another, you can charge for it. Maybe others can chime in on this as well. Sorry I can't give a more definite answer.


    Rich

  6. Default
    yes, I agree about the shoulder compartments I'm just wondering then if the rotator cuff interval is performed in the (glenohumeral compartment) and the decompression in a different compartment (subacromial space) then why would it be bundled, unless the rotator cuff interval is not considered in the "glenohumeral comp."

  7. #7
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    Quote Originally Posted by BFAITHFUL View Post
    yes, I agree about the shoulder compartments I'm just wondering then if the rotator cuff interval is performed in the (glenohumeral compartment) and the decompression in a different compartment (subacromial space) then why would it be bundled, unless the rotator cuff interval is not considered in the "glenohumeral comp."
    maybe this will help you

    http://www2.aaos.org/aaos/archives/b...apr04/code.htm
    Mary, CPC, CANPC, COSC

  8. #8
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    And this is from a April 2006 AAOS Bulletin:

    A. The AAOS Coding, Coverage and Reimbursement Committee recognizes three “areas” or “regions” of the shoulder: the glenohumeral joint, the acromioclavicular joint and the subacromial bursal space. These “areas” are clearly separate; procedures done in one area should not influence coding in a different area.

  9. Default
    thank you guys! BUT sorry, Im still confused, Can I? , Should I?, Would I dare to bill them both then???

    I know I know, coding isn't always that clear! but I think I'm going to since according to AAOS Complete Data Service showing it's not bundled! Oh well!

  10. #10
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    lol..yes you should and use the 59 modifier
    Mary, CPC, CANPC, COSC

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