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Shoulder surgery

  1. Default Shoulder surgery
    Clearnace Sale
    Hey Guys - it is the little shoulder coding chicken!!

    The payer is Blue Shieild -

    Physician performs arthroscopic rotator cuff repair, excision of distal clavicle including greater than 10 mm, subacromial decompression and debridement of Type 1 superior labral anterior and posterior tear through both the anterior and posterior portals.

    The diagnoses includ rotator cuff tear, acromioclavicular joint arthropathy, subacromial impingement and Type I SLAP tear.

    I would code 29827, 29826-51, 29824-59 and 29823-59

    Can you guys help me - I am not sure if the 29824 is billable but he did bone work greater than 10mm. The second questions is do I use 29823 or 29822 with modifier 59. Because it was both anterior and posterior portals I would conclude that is back and front and use 29823.

    What do you think?

    Thanks so much!!

    Chicken Little aka Desperate D

  2. Default
    Have you checked your NCCI edits for 29822 and 29823?

  3. Default Shoulder case

    I did check the CCI edits and it states that if the physician addresses the tear back to front then I can use 29823. 29822 would be bundled in with 29826 per AAOS - I think.

    Any help is appreciated!

    Thank you - Denise

  4. Default
    Your codes look right to me. 29824 is for a distal claviculectomy, no matter how much is removed. 29823 is good if the documentation supports it.

    Hope that helps!
    Bruce Crandall, CPC
    North Carolina Specialty Hospital
    Durham, NC

  5. Default Shoulder case
    Thanks so much for your help Bruce - really appreciate - just a little gun shy these days.

    Have a great weekend.

    MWNW Orthopedics

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