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Orthopedic Coding Alert

Reader Question:

S Codes for Thermal Shrinkage

Published on Sat Sep 01, 2001

Question: Why can I not use HCPCS code S2300 (arthroscopy, shoulder, surgical; with thermally induced capsulorrhaphy) instead of 29909? The S code is more specific.

Oregon Subscriber  
Answer: Before submitting any HCPCS Level II code to a non-Medicare carrier, you must determine whether they accept these codes. Many will not process claims with alpha-numeric codes, and some will only accept a limited number of them. Unfortunately, the Level II code you mention for the thermal capsulorrhaphy was declared "no longer valid for Medicare purposes" on Jan. 1, 2000, and is no longer accepted by Medicare. Your only recourse is to report the unlisted-procedure code 29909 (unlisted procedure, arthroscopy) with the required supporting documentation of an operative report and KISS letter. Because some carriers deem this procedure "experimental," you may also have to submit peer-reviewed articles attesting to the efficacy of this surgery. You should negotiate reimbursement for these procedures in advance rather than after the fact.
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