Mini open acromioplasty and partial repair of RCT and tuberoplasty. Acromioplasty was carried out removing half the thickness. There were large osteophytes on the greater tuberosity which were abutting the edge of the acromion and were trimmed off with a rongeur. He was able to mobilize the subscapular anterior cuff and teres minor posterior cuff back to the tuberosity area but the supraspinatus could not even be brought close to the tuberosity, therefore, a complete repair was abandoned. I want to use 23420 since this is repair of a complete avulsion of RTC and includes the acromioplasty. I figure that the tuberoplasty is just part of it and not coded separately, yes? So, since was not able to do a complete repair of the cuff I don't feel 23420 is quite right. Is adding a 52 modifier acceptable and does it explain the situation adequately or is there another way to code this? If I choose 23412, which CPT Assistant describes as (CPT codes 23410 and 23412 describe musculotendinous cuff (eg, rotator cuff) repairs involving one or two tendons or major muscles of the rotator cuff.)
can I code the acromioplasty separately? Thank you for your advice!
23412, + ?