# Shoulder-Rotator cuff procedures with allograft, any official guidance?



## kfoote16go (Sep 29, 2017)

Is there any official coding guidance on including a code for the application of allograft/xenograft in a rotator cuff reapir/reconstruction procedure or in shoulder arthroplasty .  Lots of conflicting information on the web, posts on the forum, allograft manufacturer reimbursement guides. The AHA Coding Clinic from Q1 2006, looks to be more specific to the assignment of ICD-9 "Assign code 83.63, Rotator cuff repair, for the procedure performed. The allograft graft jacket was used to reinforce the repair and is captured with the code assignment for the repair." 

Some contradictory information I have found:
- application of graft is included in the procedure so only code the RC procedure (23410, 23412, 23420, 29827) or arthroplasty (23470, 23472) alone. 
- to add modifier -22 to the primary code
- to add code +15777  (although "ie, Breast,Trunk" is part of the code and per CPT Assistant Oct 2013, its use is only in the breast or trunk) 
- to add code 17999 

Can anyone offer help, I was excited to see an AAPC Shoulder coding article in the July Healthcare Business Monthly, but no mention of graft! 

Thank you in advance!


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## sxcoder1 (Oct 9, 2017)

kfoote16go said:


> Is there any official coding guidance on including a code for the application of allograft/xenograft in a rotator cuff reapir/reconstruction procedure or in shoulder arthroplasty .  Lots of conflicting information on the web, posts on the forum, allograft manufacturer reimbursement guides. The AHA Coding Clinic from Q1 2006, looks to be more specific to the assignment of ICD-9 "Assign code 83.63, Rotator cuff repair, for the procedure performed. The allograft graft jacket was used to reinforce the repair and is captured with the code assignment for the repair."
> 
> Some contradictory information I have found:
> - application of graft is included in the procedure so only code the RC procedure (23410, 23412, 23420, 29827) or arthroplasty (23470, 23472) alone.
> ...



I have the same problem.  I have done 23412 with 17999 (used to use 15777 although decided that was incorrect), but insurance doesn't pay the 17999.  So now I'm just thinking 23420 since it includes grafting.  Not sure!


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