Wiki 29822+29826 or 29823

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Katie_Ellis

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I am having an issue deciding whether it is best or more correct to bill a 29822 with 29826 or putting all the debridement together and billing 29823.
Example: provider performs SAD with acromioplasty, a biceps tenotomy and a bursectomy.

Thank you for your help!
 
I vote for 29822 & 29826

If a subacromial decompression is performed (decompression with acromioplasty or CA ligament release) I would bill 29822 with 29826.

Due to the updated surgical policy manual this year code 29823 may only be billed with 29824, 29827 & 29828. So combining 29823 with a code set that does not include one of these codes could be problematic.

Getting insurance companies to process claims correctly is a glacial process. The CMS NCCI edit was removed on 29823 over a year ago. The surgical policy manual was updated this year specifically stating that 29823 can be billed with these codes, however insurance companies are still denying code 29823 due to the outdated rules. So just as a practical matter, to keep denials down, I would submit code 29823 with the codes the policy states that it can be paired with.

I tried combining 29826 into the debridement and billed 29823 instead and got a bunch of denials.

My two cents.
 
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I had the same scenario the other day and was also deciding between those 2 choices. I ended up going with 29822 and 29826.
 
Orthocoderpgu said:
If a subacromial decompression is performed (decompression with acromioplasty or CA ligament release) I would bill 29822 with 29826.

Due to the updated surgical policy manual this year [/B]code 29823 may only be billed with 29824, 29827 & 29828. So combining 29823 with a code set that does not include one of these codes could be problematic.

Getting insurance companies to process claims correctly is a glacial process. The CMS NCCI edit was removed on 29823 over a year ago. The surgical policy manual was updated this year specifically stating that 29823 can be billed with these codes, however insurance companies are still denying code 29823 due to the outdated rules. So just as a practical matter, to keep denials down, I would submit code 29823 with the codes the policy states that it can be paired with.

I tried combining 29826 into the debridement and billed 29823 instead and got a bunch of denials.

My two cents.
Click to expand...

Hi Orthocoderpgu,
where would I locate the updated surgical policy manual?
 
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