Wiki arthroscopic bicep tenotomy

[TamaraM]

ONE OF OUR SURGEONS HAS DONE 2 OF THESE IN 1 MONTH. I KNOW THE OPEN PROCEDURE CODE IS 23405, BUT HE VERY CLEARLY STATES THEY ARE ARTHOSCOPIC.

WE CAN BILL 29999- UNLISTED CODE W/ OPERATIVE REPORTS BUT WILL INS'S PAY? AND WHAT KIND OF CRITERIA DO WE NEED TO MEET TO BILL AN UNLISTED CODE??

 

[williamson2]

Cwil/CPC

We have been billing for arthroscopic bicep tenotomy for about 5 years now. WE use 29999 and comparison code 24310, for dx 726.12 and yes we get paid. Commercial claims will have to go hardcopy with a copy of the OP report and a brief letter stating " I am billing CPT 29999 for Arthroscopic Bicep Tenotomy as there is not a CPT code for this procedure. The closest comparison code is 24310. I am including the operative report to assist in your review". If it is a Medicare patient you will need to coordinate the claim going out and fax the signed letter and signed operative report on the same day the claim is electronically filed. In a recent Webinar, an Ortho practice out in Texas said they have recently starting receiving denials for their 29999, Arthroscopic Bicep Tenotomy whereas before they were paid. We have not experienced that problem here. Margie Vaught said that the issue has come up and AAOS is discussing that perhaps a 29822 or 29823 may be the best way to bill for the Arthroscopic Bicep Tenotomy.
Hope this helps