Outpatient Facility Coding Alert
Yes, You Can Report 2 Codes for Repairs of Both Shoulders
Question: Our surgeon wants to report two units of 23410 for repairs done in same shoulder. There were tears of both the teres major and latissimus dorsi. Repair was done through a single incision for full thickness of tears of 90% of the tendon with a very small slip of the upper border of the tendon remaining attached.
Please recommend if we can report 2 units of 23410 or only one unit of 23410 with modifier 22 for the repair of the second tear.
Answer: CPT® code 23410 (Repair of ruptured musculotendinous cuff [e.g., rotator cuff] open; acute) describes musculotendinous cuff (e.g., rotator cuff) repairs involving one or two tendons or major muscles of the rotator cuff. Teres minor, and not teres major, is a part of the rotator cuff.
Since your surgeon is repairing the teres major and latissimus dorsi, you report two units of 24341 (Repair, tendon or muscle, upper arm or elbow, each tendon or muscle, primary or secondary [excludes rotator cuff]). You won’t need to append modifier 22 (Increased procedural services) since you can report two units of 24341.
Ohio Subscriber
Outpatient Facility Coding Alert
- Podiatry:
Stamp Out Heel Spur Treatment Denials With These 3 Checkpoints
Don’t miss your chance to add other services to the claim. You’re likely familiar with [...] - Therapy Services:
Get Ready for RAC Manual Reviews for Therapy Claims Over $3700
Experts concerned that RACs get paid extra for every claim they deny. If you thought [...] - HIPAA:
Fool-Proof Your BA Contracts As They Go Under Scrutiny
Here’s why your agreement details are more important than ever. Federal authorities continue to crack [...] - ICD-10:
Learn These Foundational Phrases That Build ICD-10 Code Sets
Good news: Many go-to terms will be familiar to your staff. The focus for many [...] - You Be the Coder:
Non-Infected BB Pellet Removal From Hand
Question: A patient presented to our clinic for excision of a foreign body from his [...] - Reader Question:
Penalties Could Be Coming for Illegible Documentation
Question: My physician’s handwriting really is difficult to read sometimes, and I’m nervous because I’ve heard [...] - Reader Question:
Ask for More Details Before Submitting 31256 for Nasal Endoscopy
Question: During a nasal endoscopy, the ENT dictated that the patent maxillary antrostomy could be [...] - Reader Question:
Closing Wound With Dermabond
Question: One of the wound clinic physicians treated a patient with traumatic wounds. The patient [...] - Reader Question:
Remember Modifier 26 for Hand-Off X-Ray Interpretation
Question: I bill for both our urgent care center and the Emergency Department. An urgent [...] - Reader Question:
Separate Charges for Pilonidal Cystectomy and Z-plasty Could Apply
Question: A proctologist treated a patient for pilonidal cystectomy. A plastic surgeon was involved with [...] - Reader Question:
Simple Wart Excisions for Multiple Locations Still Mean 17110
Question: Our physician performed two wart excisions (one from the elbow, the other from the [...] - Reader Question:
Watch for Different Payer Policies on Billing Drugs With Anesthesia Service
Question: Our GI group owns its own endoscopic suite where colonoscopies are performed in this [...] - Reader Question:
Yes, You Can Report 2 Codes for Repairs of Both Shoulders
Question: Our surgeon wants to report two units of 23410 for repairs done in same [...]
