Orthopedic Coding Alert

Question: I’m new to orthopedic coding, and I am trying to understand shoulder debridement procedures. For example, with an arthroscopic shoulder debridement, I know that I can’t count the cuff debridement as well as biceps tendon toward the “discrete structures” in the procedure code. However, if the provider performs a subacromial decompression and lists debridement of the subacromial and subdeltoid bursae, are the subacromial and subdeltoid considered separate structures?

Washington Subscriber

Answer: No, the subacromial and subdeltoid bursae are not considered separate structures for reimbursement as they are the same structure.

If the provider performs an arthroscopic shoulder debridement, reported with either 29822 (Arthroscopy, shoulder, surgical; debridement, limited, 1 or 2 discrete structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of the rotator cuff, subacromial bursa, foreign body[ies])) or 29823 (… debridement, extensive, 3 or more discrete structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of the rotator cuff, subacromial bursa, foreign body[ies])), the documentation needs to clearly identify which structures the surgeon debrided.

For the hypothetical scenario you proposed, you’d have biceps tendon and subacromial/subdeltoid bursae as two discrete structures, so in that case you’ll use 29822 to report the procedure.

Mike Shaughnessy, BA, CPC, Development Editor, AAPC