Inpatient Facility Coding & Compliance Alert

Question: In one of our recent cases, the provider performed debridement of the greater tuberosity and the rotator cuff. He repaired the anterior portion of the rotator cuff, but could not repair the posterior one-third of supraspinatus and subscapularis. He then irrigated and closed the wound in layers. He documented the procedure as “partial rotator cuff repair.” In this scenario, can we report 29837?  Do we need to add any modifier like modifier 22 or 52?

Florida Subscriber

Answer: The rotator cuff is comprised of the following muscles around the shoulder: Supraspinatus, Infraspinatus, Teres Minor and Subscapularis. You can report 29827 (Arthroscopy, shoulder, surgical; with rotator cuff repair) irrespective of how many of these muscles or their tendons the surgeon repairs. 

Rotator cuff repair is a simple procedure. You need not append modifier 22 (Increased procedural services) unless your provider has documented the procedure to be extraordinarily complicated. Modifier 52 (Reduced services) also isn’t needed for procedures that don’t address all muscles or tendons.