Orthopedic Coding Alert

Question: What code would you use for a shoulder arthroscopy with thermal shrinkage of the capsule?

Wilma J. Fuller
Mid-County Orthopedic Surgery
St. Louis, MO

Answer: As experience has rapidly increased in orthopedic arthroscopy, improved techniques and instrumentation have developed to address a number of pathologic conditions including those of multidirectional instability of the shoulder. Thermal capsulorrhaphy is a procedure that uses the application of thermal energy to produce shrinkage of periarticular collagenous soft tissues, which can reduce capsular volume and assist in the treatment of shoulder instability. These improvements have increased the capabilities of the orthopedist but are developing faster than the AMA can develop CPT codes to describe these procedures. Coding to the highest level of specificity would require using the unlisted arthroscopic code 29909. But when using this code, be sure to send a descriptor to the payer so they will know what the components of the procedure are. The carrier may require a copy of the operative report to ensure correct coding, ascertain risk, severity, and complexity to pay the claim accordingly.