# Help with shoulder, debridement or synovectomy?



## kekancler (Nov 17, 2011)

Hi,

Can someone please help me. I am not going to write out the entire Op report. I just need help with this one part. " An anterior portal was then established between the biceps & subscapularis tendon, and biceps anchor was debrided, as well as synovial debridement for the synovitis that was present".

Would I use cpt 29822 or 29820 for the synovial debridement. 

Any assistance or thoughts would be greatly appreciated.

Thanks!


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## aclements (Nov 17, 2011)

This is straight from the AAOS website. I hope it helps clarify the difference between 29822 and 29820 for you.

Q. What is the difference between codes 29820, 29821, 29822 and 29823? Does the shoulder have separate compartments?

A. The AAOS Coding, Coverage and Reimbursement Committee recognizes three “areas” or “regions” of the shoulder: the glenohumeral joint, the acromioclavicular joint and the subacromial bursal space. These “areas” are clearly separate; procedures done in one area should not influence coding in a different area.

Generally, code 29820 is used for a partial synovectomy, similar to the separate procedure code. If only a diagnostic arthroscopy is performed, and some synovium is resected for visualization, only a diagnostic arthroscopy can be reported. If a partial synovectomy is medically necessary (for a redundant synovial plica or limited synovitis), code 20980 should be reported. 

Code 29821 should be used for a complete synovectomy for a synovitic disease, such as rheumatoid arthritis or pigmented villonodular synovitis, with removal of the entire intra-articular synovium.
Code 29822 covers limited debridement of soft or hard tissue and should be used for limited labral debridement, cuff debridement or the removal of degenerative cartilage and osteophytes.

Code 29823 should be used only for extensive debridement of soft or hard tissue. It includes a chondroplasty of the humeral head or glenoid and associated osteophytes or multiple soft tissue structures that are debrided such as labrum, subscapularis and supraspinatus.


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## kekancler (Nov 18, 2011)

Thanks for the reply but I still don't know whether to use a debridement code or synovectomy code for synovial debridement for synovitis???


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## mabrown1994 (Nov 18, 2011)

29822


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