Orthopedic Coding Alert

Question: Our surgeon performed arthroscopic anterior and posterior labral repairs. Should we report two units of 29806? Also, which code should we report when the surgeon repairs a pan labral tear?


Wisconsin Subscriber

Answer: You should report just one unit of 29807 (Arthroscopy, shoulder, surgical; repair of SLAP lesion) to cover both labral repairs if the surgeon repaired a true SLAP lesion. "SLAP" stands for Superior Labral Anterior to Posterior, so one unit of 29807 describes the surgeon's work repairing both the anterior and posterior SLAP lesions. If the surgeon addressed inferior labral tears (and not a true SLAP lesion), you should instead report 29806 (Arthroscopy, shoulder, surgical; capsulorrhaphy).
 
Hints for 29807: If the surgeon repairs a pan labral tear, you should report 29807. If the surgeon documents a "Bankart repair," it means that he repaired the Bankart
lesion (and repaired the labrum back to the glenoid rim). You should report 29807 for that procedure as well.

During a Bankart repair, the surgeon may also tighten up the capsule, which he'll document as "capsulorraphy." You should report 29806 for this service.

Some insurers may allow you to report both 29806 and 29807-59 (Distinct procedural service) if the surgeon repairs both the capsular ligament and labrum, but via separate sutures. For example, if the surgeon repairs a SLAP lesion and an inferior glenohumeral ligament during the same operative session, you should be able to report both codes.