Can 29822 and 29823 be billed together?
Before 2021, arthroscopic shoulder debridement codes 29822 and 29823 were only defined as “limited” and “extensive.” The AAOS Coding Coverage and Reimbursement Committee (CCRC) provided guidance to members that 29822 should be used when one to two distinct sites were debrided and that 29823 should be used when three or ...
What is the CPT code 29822?
CPT 29822 — Arthroscopy, shoulder, surgical; debridement, limited, 1 or 2 discrete structures (e.g., humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of the rotator cuff, ...
Can CPT code 29823 be billed alone?
If another arthroscopy procedure is billed and paid for the same day, on the same shoulder, for the same beneficiary, on the same date of service, the extensive debridement (code 29823) is not separately payable and CPT code 29823 will be denied.
Can CPT 29806 and 29823 be billed together?
CPT code 29823 Arthroscopy, shoulder, surgical; debridement, extensive, is bundled with CPT 29807 Shoulder Arthroscopic, repair SLAP Lesion or CPT 29806 Shoulder Arthroscopic, Capsulorrhaphy, for the same date of service, for the same shoulder, for the same beneficiary, and for the same encounter.
Can CPT code 29823 and 29825 be billed together?
For example, CPT 29823 indicates arthroscopy of the shoulder, debridement extensive, while CPT 29825 indicates arthroscopy with lysis and resection of adhesions. If the physician performs both procedures on the left shoulder and the coder bills the procedures together, they're considered bundled services.
Can CPT code 29827 and 29823 be billed together?
Per the 2017 CMS NCCI Surgical Policy Manual code 29823 CAN be billed with 29824, 29827 & 29828 ONLY.
What is Tenodesis of long tendon of biceps?
What is the biceps tenodesis procedure? The biceps tenodesis procedure treats shoulder and biceps muscle pain and weakness that happens when you tear your long head biceps tendon. This tendon is located at the top of your bicep muscle. It's connected to your labrum, which is cartilage that lines your shoulder socket.
What is subacromial decompression of shoulder?
Shoulder subacromial decompression (also called acromioplasty) is a surgical procedure to treat shoulder impingement, a common condition that causes weakness in your shoulder and pain when you raise your arm above your head. It is performed using keyhole surgery.
What is the CPT code for subacromial decompression?
29826CPT code 29826 (arthroscopic subacromial decompression), may be reported in conjunction with an open rotator cuff repair (23412) and arthroscopic distal claviculectomy (29824).
Is a SLAP tear the same as a labrum tear?
Superior Labrum, Anterior to Posterior tears (SLAP tears), also known as labrum tears, represent 4% to 8% of all shoulder injuries. The L in SLAP refers to your glenoid labrum. Your labrum plays two important roles in keeping your shoulder functioning and pain free.
What is the difference between 29806 and 29807?
Error #3: Unbundling 29806 and 29807 for SLAP If the repair is a SLAP, you'd code work done on the upper half of the labrum as 29807 (Arthroscopy, shoulder, surgical; repair of SLAP lesion). If the repair was in the lower half of the labrum, you'd use instead code 29806 (Arthroscopy, shoulder, surgical; capsulorraphy).
Is biceps tenodesis part of a total shoulder arthroplasty?
Total shoulder arthroplasty is becoming increasingly common. A biceps tenodesis or tenotomy has become a routine part of the operation. There are several advantages to a tenodesis or tenotomy.
What is CPT code 29822?
This email will focus on changes to CPT Codes 29822/29823 debridements relative to the shoulder . It will help you determine when the removals are separate and distinct from other procedures performed in the same operative session as well as the difference between limited vs. extensive debridements as it relates to 29822/29823.
Can you use one code for 2 structures and another for the other 3?
You can’t use one code for 2 structures and another for the other 3. Important note: Keep in mind that if you debride the structure prior to doing a repair, that debridement is considered inclusive in the repair.
What is 29826 code?
What to code when only an Acromioplasty is performed alone (29826) 29826 is defined as an Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (ie, arch) release, when performed (List separately in addition to code for primary procedure).
How much does Medicare pay for shoulder arthroscopy?
For example, the Medicare allowable for a shoulder arthroscopy with lysis and resection of adhesions (CPT 29825) is $593 while the average commercial payment for the procedure in $1,350 — a payment of more than double the Medicare allowable.
Can you use a modifier with every scenario?
Remember the terms “separate” and “distinct.”. Simply because you can use a modifier doesn’t imply automatic application of a modifier with every scenario. A coder shouldn’t confuse the surgeon’s repair of the labrum by attaching it to the capsule as a separately identifiable capsulorrhaphy.
Does 29807 reimburse for a SLAP?
If 29807 is a SLAP type 1 or 3 lesion do not append modifier 59 to 29807 and 29807 does not reimburse separately with 29806. If 29807 is performed on one shoulder and 29806 is performed on the opposite shoulder append modifier 59 to one of these procedures and both procedures reimburse separately.
Appeal Letter Templates
Our appeal letter templates may be used to appeal inappropriate denials for shoulder debridement, CPT codes 29823 and 29826 reported in conjunction with codes 29824, 29827, and 29828. The letter offers the framework needed to support appeals for denied procedures and may be altered to fit the specific situation.
Coding Resources from AAOS Global Service Data Guide for Orthopaedic Surgery
Find below resources from the 2020 AAOS Global Service Data Guide that support reporting shoulder arthroscopy procedure codes separately. Each page is in PDF format for easy download and/or print.
