Wiki 29823 vs 29822

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cherylbr

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As per the new code descriptions 29822 and 29823 effective Jan 1st, 2021
29822 - Arthroscopy, surgical; debridement , limited 1 or 2 discrete structures
29823 - Arthroscopy, surgical; debridement, extended, 3 or more discrete structures.

I am unclear if you can count a structure in the debridement if it is coded for something else done in that structure. For example, if you are coding 29827 for repair of the rotator cuff would you still be able to count debridement of rotator cuff in when counting for the debridement code? Do the counting of structures for debridement have to be in structures that are not otherwise worked or coded in?

Thanks,
Cheryl
 
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Orthocoderpgu said:
NO! You cannot count debridement that is part of the repair. If they debride the rotator cuff, and repair the rotator cuff, you cannot count the debridement towards
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Orthocoderpgu said:
NO! You cannot count debridement that is part of the repair. If they debride the rotator cuff, and repair the rotator cuff, you cannot count the debridement towards 29823.
Click to expand...
Does this also apply to any other structures that are worked on? Example, biceps tenodesis 29898, and acromioplasty 29826? If coding for those then I assume you cannot count those for debridement either, is that right?
 
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Can you count debridement of an inflamed subacromial bursa when they go on to perform a subacromial decompression with acromioplasty (29826)?
 
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These are really invaluable if you are coding orthopedic surgery. https://www5.aaos.org/store/product...28983.1641496967-931131646.1640876434&ssopc=1

You can't "double" count the structure being debrided if it was part of the greater procedure. As stated above you can't count debridement and prep of the RC in reporting 29823 if 29827 is also being reported. You can't count subacromial work if it is also being reported in 29826. You can't count biceps debridement if they are also doing 29828.

Here's a link to a discussion on this from 2021: https://www.aapc.com/discuss/threads/29823-extensive-intra-articular-debridement.182938/post-501019
 
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I emailed the Karen Zupko Coding Coach about the subacromial bursa recently! Here's my question & their answer:

Question: My physician performed a shoulder arthroscopy with rotator cuff repair, debridement of the labrum, humeral head chondromalacia, and an inflamed subacromial bursa, plus a subacromial decompression with acromioplasty. Can I count the debridement of the subacromial bursa as a discrete structure to make this debridement 3 structures (29823), or is it part of the subacromial decompression (29826)? Thank you!

Answer: Debridement of the subacromial bursa is inclusive to code 29826. If the physician performs a combination of soft tissue debridement and acromioplasty, only that code is used. You would not also count the soft tissue debridement toward 29822 or 29823.
 
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