Orthopedic Coding Alert

Reader Question:

Arthroscopy

Question: Ive recently been told that when a partial claviculectomy is done arthroscopically, we should use the unlisted arthroscopic code (29909). My argument is that 23120 states claviculectomy; partial. It does not specify an open procedure, only that a portion of the clavicle was removed. If it does not specify open, why cant 23120 be used with the arthroscopic claviculectomy? Using an unlisted procedure, especially with scope procedures, is always fraught with denials even when we submit supporting documentation and an explanatory letter.

Oregon Subscriber

Answer: The procedure you describe is an arthroscopic Mumford repair. Code 23120 (claviculectomy; partial) remains the most accurate code to use for the procedure. It is similar in concept to, say, 27425 (lateral retinacular release [any method]). It should only be a matter of time before CPT adds the language any method to 23120, which would certainly make things easier. In the meantime, when dealing with nonspecific codes such as these, you must continue sending in supporting documentation and additional explanations of what was done in the operative setting.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Which Codify by AAPC tool is right for you?

Call 844-334-2816 to speak with a Codify by AAPC specialist now.