# SLAP w/ glenohumeral debridement & tenotomized the biceps



## bmeech (Apr 29, 2009)

Would like clarification if this "tenotomized biceps as well as labral fraying shaved back" would fall into 29823, due to in Glenohumeral joint / Subacromial space or just 29822 & 29826 (which includes the 29822).  Note: that a 23430 was also done so would not be a scope tenotomy (29999).

Plan 23430, 29823-59 or 23430 & 29826-59. (includes 29822)
See below for OP note:

We then proceeded to make a standard posterior portal and began our diagnostic arthroscopy into the glenohumeral joint first. We then under direct vision made our anterior portal with use of a spinal needle. Once this was in place, we then placed a probe. The patient had a type 2 SLAP lesion of his biceps at his biceps insertion. Otherwise, glenoid face and humeral head were intact. Rotator cuff was intact. There were no loose bodies in his axillary pouch. We then proceeded to take arthroscopic scissors and tenotomize the biceps tendon. We then used an arthroscopic shaver to shave this back as well as any labral fraying that was noted throughout this area. We then entered the subacromial space with our camera and made our lateral portal again with use of a spinal needle and a cannula. We then with use of electrocautery, we were able first debride bursa and identified our anterolateral aspect of the acromion. We then used a shaver to perform a bursectomy. Once this was accomplished, we then took the bur and performed our _____ resection. Once this was accomplished satisfactorily, we then removed all arthroscopic instruments. We then reprepped with a DuraPrep solution. 

I then proceeded to make an approach for the subpectoral tenodesis, making a longitudinal incision with the midportion of this centered over the pectoral insertion. We incised down through the skin and subcutaneous tissues down to the level of the pec fascia, which I incised. With the tenotomy scissors, I was then able to identify the biceps tendon. We then placed a Chandler to pull our strap muscles medially and then release the pectoral insertion partially as well as placing the arm in _____. We then placed a whipstitch in our biceps tendon, and then placed our guidepin for our reamer. We then drilled our 8-mm acorn reamer. We then put a tenodesis screw around our whipstitch and placed the PEEK screw in place. We had excellent purchase with this screw. We then over tied the 2 suture ends together. 

Thank you so much in advance
Brenda M, CPC


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## mbort (Apr 29, 2009)

I say 29826, 29822-59 and of course your 23430.  The 29822 does bundle but the 59 is justified because its the labrum that was debrided which is separate from the SAD.

Mary, CPC, COSC





**corrected typo** THANKS!!


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## bmeech (Apr 29, 2009)

Thank so much Mary, that is what I wanted to do, but really needed confirmation on my compartments (2 of the 3 to qualify for 29823)
Have a Great Weekend !!
Brenda M.CPC


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## bmeech (Apr 29, 2009)

Also I know you did not mean 28296 but a 29826, in case someone is reading this...


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## mbort (Apr 29, 2009)

Thanks for having my back Brenda...I fixed it


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