Orthopedic Coding Alert

Question: My orthopedist performs an arthroscopy on a patient's shoulder. What is the difference between a synovectomy and debridement service? How should I determine if it is partial/limited or complete/extensive?

Alabama Subscriber

Answer: Generally, you should reserve debridement for situations where your physician debrides articular cartilage. On the other hand, you would use synovectomy codes when your physician removes only the soft tissue.

Partial/limited: A partial synovectomy (29820, Arthroscopy, shoulder, surgical; synovectomy, partial) or limited debridement (29822, ... debridement, limited) describes work the physician does in a portion of the shoulder.

Complete/extensive: If your physician does a complete synovectomy (29821, ... synovectomy, complete) or extensive debridement (29823, ... debridement, extensive), then his documentation should support work in both the front and back (anterior and posterior) of the shoulder.

Experts advise you to encourage your surgeons to use the terms "limited" and "extensive" when describing arthroscopic debridement procedures. The surgeons are the only ones in a position to make that determination.