Wiki 29823 with codes 29827, 29828, and 29824

[FBETHUNE]

Please if someone can clarify for me, it has been approved for the code 29823 to be used with the codes 29827, 29824, and 29828 as of 7/1/16. Is this if the extensive debridement was on something other than the rotator cuff, bicep tendon or the distal clavicle if working or repairing in the same session? For example my doctor wrote "Extensive debridement of the undersurface of the cuff tear was performed. The biceps was then released proximal to the sutures and the stump and labral tear was debrided back extensively". Can someone please clarify for me?

 

[Orthocoderpgu]

The edit was removed from 29823 on 7/1/16 however the coding policy manual did not get updated until 1/1/2017. So for any dates prior to 1/1/2017 you are at the mercy of the insurance and how they process the claim. Even in 2017 they are still denying but at least we have grounds for appeal since the edit was removed and the policy manual specifically states that 29823 can be billed with the other codes.

The important thing to understand is that any debridement that you are counting towards 29823 CANNOT be related to a procedure. For example. A rotator cuff tendon is frayed and torn. The tendon is debrided before its anchored down. This debridement is part of the RTC repair. Same thing for a tenodesis. The frayed tendon would be debrided smooth before being anchored down to the lateral humerus.

So if your physician extensively debrided a rotator cuff tendon before repair, its included with 29827 and does not count towards 29823.