Wiki +29826

lcole7465

Expert
Messages
276
Location
Brooklyn, MI
Best answers
0
Ok, so there's a little discussion going on with the Add-on code 29826.

The surgeon performed a decompression only with no acromioplasty. Would this be only coded as a debridement (29822/29823) depending on the op report below. I'm really not finding any information that is definitive or leaning in one direction more.

Patient is standard posterior arthroscopic portal portal established. The intra-articular findings include no significant articular cartilage changes in the humeral head or the glenoid. The biceps was intact. There was a significant tear of the labrum superiorly from about the 10 o'clock position around to the 2 o'clock position. There was a partial rotator cuff tear. A spinal needle was used to create an anterior working portal. Through this anterior working portal debridement of the superior labral tear was done. This did not require labral repair. A limited synovectomy and debridement of the partial rotator cuff tear was also done. The scope was placed both anteriorly and posteriorly in the shoulder and we worked both anteriorly and posteriorly in the shoulder. No significant other abnormalities findings were noted.
*
The scope was then placed from the posterior portal into the subacromial space and a lateral working portal was established. The seem to be somewhat of a tight lateral space. A subacromial bursectomy was performed and then the bur was used to perform a bony decompression of the subacromial space. This decompressed the subacromial space nicely.
 
This reads as he did both an extensive debridement of the shoulder labrum and rotator cuff. The acromioplasty was the section in the operative note "...and then the bur was used to perform a bony decompression of the subacromial space." He removed bone from the under side of the acromin with the bur.

Therefore

29823 - RT or LT modifier
29826 - RT or LT modifier

all diagnosis codes should be for both CPT codes
 
29826 is for two procedures

If the physician performs a subacromial decompression alone, it's debridement (29822, 29823)

In order to bill code 29826 you have to perform the subacromial decompression and:

* Acromioplasty
* CA ligament release

without one of these procedures being performed with the subacromial decompression, you can't bill 29826.

Look up the code in the CPT, it clearly spells this out.

Your op note shows that both a SAD was done as well as an acromioplasty. So this note supports 29826. Debridement is not counted if it's in preparation of a repair.
 
Last edited:
Top