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Arthroscopic remplissage & arthroscopic bankart procedure

  1. Default Arthroscopic remplissage & arthroscopic bankart procedure
    Medical Coding Books
    I sent a claim to Medicare for a surgery where patient had an arthroscopic bankart repair
    (29806) for anterior instability and an arthroscopic remplissage procedure (29999) for a Hill Sach's defect. I sent a letter with the claim explaining why we used code 29999 and compared the remplissage procedure to code 23465. Medicare bundled the remplissage procedure into the Bankart repair and I am not sure how to appeal this. Does anyone have any suggestions?

  2. Default
    I can see where they would deny it, 29806 is a capsulorrhaphy and so is the procedure that is the closest description. It seems more of a way to perform the procedure more than a procedure itself. Read this first and go from there...
    Bruce Crandall, CPC
    North Carolina Specialty Hospital
    Durham, NC

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