Results 1 to 2 of 2

Acromioplasty with debridement??

  1. Default Acromioplasty with debridement??
    Exam Training Packages
    dr wants to bill 23700, 29826 & 29822 for the following but I disagree. The MUA is inclusive according to CCI & CPT guidelines, however I'm a bit undecided about CPT 29822-59 because I think it looks like it was done for visualization purposes & cleaning out blood clots due to the MUA??
    Thanks


    DX: Adhesive capsulitis & Chronic impingement syndrome
    Procedure: MUA with debridement of glenohumeral joint and bursectomy, acromioplasty and resection of coracoacromial ligament.

    GROSS FINDINGS:There was marked restricted motion of the right shoulder during manipulation. There was audible lysis with multiple adhesions. In the glenohumeral joint, there was some bleeding following the manipulation, but the remaining structures seemed to be grossly intact. In the subacromial bursa, there was thickened subacromial bursitis, but somewhat of an anterior acromion spur. At the end of the procedure, this area was cleaned of any excessive bursal tissue and the acromion was flattened. The coracoacromial ligament had been released.

    OPERATIVE PROCEDURE:With the patient under right scalene block and sedation, the right shoulder was manipulated with audible lysis of the adhesions and brought through normal range of motion. Following this, the patient was in a beachchair positioner and the right shoulder was properly prepped and draped and arthroscopic arthrotomy carried up in the posterior portal. Initially, poor visualization was obtained in the glenohumeral joint, so the arthroscope was directed from the lateral mid portal with the posterior portal used for an accessory portal.

    Looking into the subacromial space, the shaving device, the electroblade, was used from the posterior portal and the bursectomy was accomplished as well as the acromioplasty and resection of the coracoacromial ligament. Following this, the instrumentation was redirected into the glenohumeral joint and much better visualization was able to be obtained. There were a number of blood clots from the manipulation, which were irrigated and débrided out. Following this, some Depo Medrol was inserted into the glenohumeral joint to help reduce the inflammatory response and the arthroscopic portals were closed with interrupted sutures of 3 0 nylon. Betadine adaptic compression dressing was applied. The patient returned to the recovery room in satisfactory condition.

  2. #2
    Default
    Quote Originally Posted by BFAITHFUL View Post
    dr wants to bill 23700, 29826 & 29822 for the following but I disagree. The MUA is inclusive according to CCI & CPT guidelines, however I'm a bit undecided about CPT 29822-59 because I think it looks like it was done for visualization purposes & cleaning out blood clots due to the MUA??
    Thanks


    DX: Adhesive capsulitis & Chronic impingement syndrome
    Procedure: MUA with debridement of glenohumeral joint and bursectomy, acromioplasty and resection of coracoacromial ligament.

    GROSS FINDINGS:There was marked restricted motion of the right shoulder during manipulation. There was audible lysis with multiple adhesions. In the glenohumeral joint, there was some bleeding following the manipulation, but the remaining structures seemed to be grossly intact. In the subacromial bursa, there was thickened subacromial bursitis, but somewhat of an anterior acromion spur. At the end of the procedure, this area was cleaned of any excessive bursal tissue and the acromion was flattened. The coracoacromial ligament had been released.

    OPERATIVE PROCEDURE:With the patient under right scalene block and sedation, the right shoulder was manipulated with audible lysis of the adhesions and brought through normal range of motion. Following this, the patient was in a beachchair positioner and the right shoulder was properly prepped and draped and arthroscopic arthrotomy carried up in the posterior portal. Initially, poor visualization was obtained in the glenohumeral joint, so the arthroscope was directed from the lateral mid portal with the posterior portal used for an accessory portal.

    Looking into the subacromial space, the shaving device, the electroblade, was used from the posterior portal and the bursectomy was accomplished as well as the acromioplasty and resection of the coracoacromial ligament. Following this, the instrumentation was redirected into the glenohumeral joint and much better visualization was able to be obtained. There were a number of blood clots from the manipulation, which were irrigated and débrided out. Following this, some Depo Medrol was inserted into the glenohumeral joint to help reduce the inflammatory response and the arthroscopic portals were closed with interrupted sutures of 3 0 nylon. Betadine adaptic compression dressing was applied. The patient returned to the recovery room in satisfactory condition.
    I personally would agree w/ you - the way it is dictated - the doc caused the clots - so he should clean them up - I know for instance,medicare says if you have hemorhage during surgery you are responsible for taking care of it and cannot charge.

    I would not charge the 29822 based on this report.

Similar Threads

  1. I'm thinking debridement more than acromioplasty
    By skorkfranks in forum Orthopaedics
    Replies: 1
    Last Post: 10-11-2012, 10:19 AM
  2. Acromioplasty?
    By richelle25 in forum Orthopaedics
    Replies: 2
    Last Post: 03-08-2011, 03:09 PM
  3. help with rotato cuff, acromioplasty, debridement
    By ggparker14 in forum Orthopaedics
    Replies: 1
    Last Post: 02-25-2011, 07:07 AM
  4. Re: open acromioplasty w/ debridement of glenoid
    By lheathman in forum Orthopaedics
    Replies: 1
    Last Post: 11-19-2009, 03:51 PM
  5. acromioplasty??
    By trose45116 in forum Orthopaedics
    Replies: 0
    Last Post: 03-05-2009, 01:21 PM

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?

Login

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.