Wiki Arthroscopic rotator cuff revision

[jalabergeron]

Hopefully, a simple question: For an arthroscopic shoulder rotator cuff revision, would you code 29827 (Arthroscopy RCR repair) or use an unlisted code 29999 (unlisted procedure, arthroscopy)? Reason I'm asking, the insurance company is denying 29827. Wonder what the masses are coding for this. TIA!

 

[amyjph]

It's still 29827. I probably would not use an unlisted. Sometimes IF the op report documentation supports it, you would append a 22 mod. However, there could be other reasons for denial. It's tough to say without specifics and knowing what was done during the case. Sometimes it's superior capsule reconstruction if the re-tear is massive. There is the bio-patch sometimes like Regeneten.
The last I knew AMA instructed 29999 for superior capsule reconstruction via scope, but it's been a bit since I coded one. Prior times, 29827 was being used when these very first started to be done.

 

[Orthocoderpgu]

In ten years I have never had a RTC repair denied. What did they give you as a reason for the denial?