AAPC - Back to school
Results 1 to 4 of 4

Thread: Open Rotator Cuff Repair and Coracoacromial Ligament Release w/ Acromioplasty

  1. #1

    Default Open Rotator Cuff Repair and Coracoacromial Ligament Release w/ Acromioplasty

    AAPC: Back to School
    I was wondering if we could get some resolution on this. It is my understanding the shoulder is composed of two compartments, the glenohumeral and the acromioclavicular. The Rotator Cuff is in the glenohumeral joint and coracoacromial ligament and the acromion is located in the acromioclavicular joint. Why is the 23412 and the 23415 inclusive of each other and why is the the "59" modifier not payable under this circumstance?
    Thank you for your response.
    Ella N

  2. #2


    The coracoacromial ligament release is actually part of 23412 according to Ingenix's "lay description".
    Check your operative report - you may wish to use 23420 which includes the RTC reconstruction, acromioplasty, coracoacromial ligament release etc...

    Ella, The lay descriptions are quite long... I would be happy to e-mail this info to you - just send me your e-mail address. - Have a great day!

  3. #3
    Join Date
    Apr 2007


    use caution with the 23420 though, it is for a "complete" rotator cuff tear. If I remember correctly three of the four tendons must be repaired. (infraspinatous, supraspinatous, subcapularis, teres minor).

    I very rarely see documentation that supports this code.

  4. #4


    Ella, that's right 23420 is for 'complete' RC repair and you need to have documentation for atleast 3 tendons being repaired out of S.I.T.S
    Also, when you check CCI edits, you would find that 23412 and 23415 are modifier allowed, so in my opinion if you have a supporting separate and distinct dx available and the procedures are being performed distinct enough from each other (via separate portal, etc.), then you should be in a position to report them with 59.

Similar Threads

  1. Open rotator cuff repair and open biceps tenodesis
    By cathy56 in forum Orthopaedics
    Replies: 3
    Last Post: 10-19-2015, 09:03 AM
  2. Replies: 0
    Last Post: 05-15-2012, 07:51 AM
  3. Open with scoped rotator cuff repair
    By kshulund in forum Orthopaedics
    Replies: 1
    Last Post: 03-24-2010, 12:01 PM
  4. open rotator cuff repair with scoped
    By kshulund in forum Outpatient Facilities
    Replies: 1
    Last Post: 03-24-2010, 05:23 AM
  5. open rotator cuff repair
    By LTibbetts in forum Orthopaedics
    Replies: 1
    Last Post: 12-31-2008, 02:45 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.