Wiki 23415 or 29826

[dmakepeace]

Hi,
Please see attachment and let me know your opinion on what code would be supported by the documentation: 23415 or 29826?

 

[Orthocoderpgu]

Neither 23415 or 29826 is supported in that documentation. Code 29824 is supported. Code 29823 is supported.

Code 23415 requires an incision which is not documented.
Code 29826 requires a subacromial bursectomy which is not documented.

I'm assuming a RTC repair was done since there were sutures placed, but neither of these procedures would require sutures.

 

[dmakepeace]

Thanks for your response! Yes, RTC was done. 29826 description is decompression of subacromial space with partial acromioplasty, with coracoacromial ligament release, when performed---I don't see anything about bursectomy in the description---will you please elaborate

 

[Orthocoderpgu]

Decompression of the subacromial space is done by resecting the subacromial bursa. The coding companions explain this.

 

[dmakepeace]

Thanks for your help--- I will have to look into getting those!!

 

[Orthocoderpgu]

Thanks for your help--- I will have to look into getting those!!

If your coding shoulder surgeries your really going to need to print out the CMS NCCI Surgical Policy Manual. It gives very specific coding instructions for the shoulder. I know that everyone frequently refers to what AAOS says on a coding subject, but the truth is that AAOS and CMS agree about 95% of the time. And it's the 5% that gets you. The first thing to do when coding surgeries is look at who the insurance is. That is going to dictate how you can code.