Post Op: Massive rotator cuff avulsion with painful shoulder.
The arthroscope was inserted through a small stab wound at a standard posterior portal by first inserting a spinal needle filling the joint with sterile saline and then making a small stab wound and introducing the scope sheath with obturator into the joint. Return of the injected fluid was noted and the scope was inserted and found to be well positioned in the joint. The joint appeared totally continuous with the subacromial space and only an edge of rotator cuff at the level of the glenoid was found. The edge was frayed as was the synovium and this was debrided with an intraarticular shaver and an ArthroWand, which was also used to achieve hemostasis. A bur was used to resect an anterior acromial spur and flatten the underside of the anterior acromion. The combined joint and subacromial space were then irrigated and drained of all fluid.
29826 is bursectomy with partial acromioplasty. I do not see enough documentation. I was considering 29826-52(for acromioplasty) and 29822-59 (for debridement of the frayed RC) in the glenoid. Any other thoughts would be greatly appreciated!!!
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