Orthopedic Coding Alert

Question: What criteria should I use to distinguish between a limited shoulder debridement (29822) and an extensive shoulder debridement (29823)?

Ohio Subscriber

Answer: According to the AAOS Global Service Data for Orthopaedic Surgery, a limited debridement (29822) includes labral debridement, synovectomy, removal of humeral or glenoid osteophytes, articular shaving and/or chondroplasty, and diagnostic arthroscopy.

An extensive debridement, coded as 29823, includes the same procedures listed under 29822 as well as biceps tendon and rotator cuff debridement and abrasion arthro-plasty. Because this code pays about $50 more than 29822, many coders are tempted to use it for any shoulder debridement that the orthopedist deems complex. But you should report it only when the surgeon performs all of the procedures listed.