Orthopedic Coding Alert

Question: I have a report for an arthroscopy for subacromial space decompression (29826), distal claviculectomy scope (29824), and a scope for a coracoid process resection (29999). Does 29826 include the arthroscopic coracoid decompression? Michigan Subscriber Answer: No, 29826 (Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with or without coracoacromial release) does not include the arthroscopic coracoplasty (partial resection of the coracoid process's posterolateral side). You should be able to report the procedure separately with 29999 (Unlisted procedure, arthroscopy), as you suggest. Here's why: You won't find a CPT code describing arthroscopic or open coracoplasty. CPT guidelines state, "Do not select a CPT code that merely approximates the service provided. If no such specific code exists, then report the service using the appropriate unlisted procedure or service code." For an arthroscopic procedure, this code is 29999. You should compare the unlisted service to another code to help the payer decide on reimbursement. Typically, you can compare arthroscopic coracoplasty to 29826. Watch out: You-re already reporting 29826 on this claim, so your best bet may be using 23182 (Partial excision [craterization, saucerization or diaphysectomy] bone [e.g., osteomyelitis], scapula) or 23190 (Ostectomy of scapula, partial [e.g., superior medial angle]) for comparison.