# 29822-59 separately??



## BFAITHFUL (Jul 5, 2010)

im billing the following as 29828, 29826 & 29824 but not too sure if I should be billing separately for RC debridement? 29822-59?



a posterior portal was used it was found that the biceps was flattened and tendonosis and the undersurface of the rotator cuff had a tear and was slightly elevated off its footprint anteriorly.  This was marked with an 18 gauge spinal needle and a suture and the biceps tendon using an 18 gauge spinal needle pulling through an anterior portal through the biceps tendon placing a bird beak near the attachment of the biceps grabbing the #1 prolene suture and pulling it percutaneously.  once this was accomplished, the biceps tendon was covered with scissor and the undersurface of the rotator cuff was debrided with the shaver.  the arthroscope was reintrodueced in the subacromial space, which had thickened bursa through a direct lateral portion first identifying an 18 guage spinal needle. a 6mm cannular was inserted.  this two limbs of the sutures were grabbed, a knot pusher was pushed down each libms make sure they were not tangled.  a duncan loop two half hitches, reverse half hitch and a reverse post were tied and then cut.  a bursectomy was performed with a shaver.  the undersurface of the acromion was debrided with bipolar radiofrequency wand.  acromiocoracoid ligament was resected and the medial portion of the acromion was debrided with an acromionizer bur as well as a distal clavicle.  this was completed with an unsheath bur until 8mm of the distal clavicle was removed and clearly visualized.  the arthroscope was then place in the lateral portal with the sheath is in the posterior portal and the under surface of the acromion was debrided with completed.  the bursa was debrided of the rotator cuff.  rotator cuff was probed there was no evidence of a tear.  therefore, repair was not necessitated.


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## nyyankees (Jul 6, 2010)

sounds good to me. the RC is a separate issue from the biceps repair, AC joint excision and decompression.


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## BFAITHFUL (Jul 6, 2010)

that's what I thought but it when it comes to billing 29822 separately I always like others' opinions.   

Thanks


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## DOVERRED (Jul 6, 2010)

29822 is considered as intergral part of codes 29826 and 29828 according to the orthopaedic coding companion  nad cci edit..that is my take on it!


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## nyyankees (Jul 6, 2010)

DOVERRED said:


> 29822 is considered as intergral part of codes 29826 and 29828 according to the orthopaedic coding companion  nad cci edit..that is my take on it!



The 59 modifer and dx of RC tear (727.61) would overide the edits. There's a great article on the Orthopedic/Pink Sheets website on this type of scenario.


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## BFAITHFUL (Jul 6, 2010)

I always thought as long as the debridement was done on a separate structure than it can be billed according to AAOS.    & as far as the dx I was actually thinking dx: 840.4 because I code for an ASC & don't really know if it's nontraumautic vs traumatic /  acute vs chronic


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## nyyankees (Jul 6, 2010)

BFAITHFUL said:


> I always thought as long as the debridement was done on a separate structure than it can be billed according to AAOS.    & as far as the dx I was actually thinking dx: 840.4 because I code for an ASC & don't really know if it's nontraumautic vs traumatic /  acute vs chronic



840.4 is fine with your scenario. If you give me your email address I can email the article.


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## BFAITHFUL (Jul 6, 2010)

oh,... that would be great!    email address is bethsaidarramos@gmail.com

Thank you!


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## debcoker (Jun 23, 2014)

*tendonosis*

I have an MRI report that lists "tendonosis" of the shoulder, as well as a "full thickness tear of the supraspinous tendon. I can't find a code for tendonosis anywhere, and when I search, it states that tendonitis and tendonosis are not the same. Can anyone help please?? Thanks!
dcoker@moreoflife.com


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## coderguy1939 (Jun 23, 2014)

Take a look at 726.10 and see if it might apply for the tendinosis.  A full thickness tear of supraspinatus would be 840.6 for traumatic and if chronic take a look at 727.61 as a possibility.


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