Wiki 29826 and Medicare

[coderguy1939]

Anyone know if Medicare has put out an officicial policy on coding 29826 when it is the only procedure performed? Has CMS fallen in line with CPT & AAOS which tell you to use 29822 or 29823?

Any help would be appreciated.

 

[Peter Davidyock]

Effective 01.01.12 +29826 may only be reported in addition to the code for the primary procedure. The code was revised and became an add on.
If it is the "only" procedure performed in the session it should be reported as an unlisted code.

 

[coderguy1939]

Both AAOS and CPT have said that an unlisted code should not be used, that 29822 or 29823 are the appropriate codes depending on the extent of work done. Medicare, however, doesn't seem to have issued any clarifications on how to code arthroscopic SAD when it is the only procedure performed.

Do you have any information from CMS indicating that 29999 would be the appropriate code?

Thanks.

 

[bethh05]

Here is an article from Becker's ASCREVIEW:
http://www.beckersasc.com/asc-codin...-financial-hit-to-both-ascs-and-surgeons.html
It does state that the current recommendation is to use an unlisted which is noncovered by MCR in an ASC. Fortunaltely I have not had this issue yet. It also states the the final rule will be published on/after November 1st.