Orthopedic Coding Alert

Question: According to the Correct Coding Initiative (CCI), 29822 (Arthroscopy, shoulder, surgical; debride-ment, limited) is included in 29826 (Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with or without coracoacromial release), but if the surgeon debrided the labrum, supraspinatus and subscapularis, couldn't modifier -59 (Distinct procedural service) be appended to indicate that the labrum debridement is separate from the arthro-scopic decompression?

Wisconsin Subscriber

Answer: The American Academy of Orthopaedic Surgeons' (AAOS) position on this topic differs from the CCI edits. According to the AAOS, "decompressive subacromial arthroscopic surgery (29826) may be reported in addition to 29822."

If you are reporting these two services to a carrier that uses CCI (such as Medicare), bill 29826 on the first line item, followed by 29822-59 on the second line to ensure that both codes will be reimbursed.