Wiki Arthroscopic shoulder procedure questions

[jdibble]

Hi All!

I am trying to figure out how to code some arthroscopic procedures and the more I try to figure it out the more I am confusing myself! If some one could help explain this to me it would be appreciated!!

First - if the doctor does a subacromial decompression along with other procedures (i.e. rotator cuff repair, debridement, etc.) but does not do an acromioplasty can I still use 29826 or does the acromioplasty need to be done to use that code? And if it can't be used, what code would be used?

Second - my doctors are documenting that they did an arthroscopic Suprascapular nerve decompression at the same time as other procedures (i.e. rotator cuff, debridement, tendodesis, etc.). Is this billed separately or bundled with the other procedures. If it is billable, the unlisted arthro code 29999 would be billed, however what code would this be comparable to?

Any help would be appreciated. I am hoping for an answer as soon as possible as my claim is pending for the right answer!!

Thanks!!

Jodi Dibble. CPC, COC

 

[Orthocoderpgu]

29826 requires acromioplasty

29826 requires acromioplasty, period. If there is no acromioplasty, then you count the subacromial decompression towards 29823 (29822 CANNOT be billed unless it is the ONLY code being billed).

Be careful with debridement. Any debridement that is performed in preparation for a restorative procedure (RTC, tenodesis) is included with that procedure. In order to report debridement, 29823, it must be done on structures that are not repaired, basically.

There is no arthroscopic code for the nerve decompression so I would use 29999.

For shoulder coding there are two very good articles in the monthly magazines within the past two years: March 2016 & July 2017.

 

[jdibble]

29826 requires acromioplasty, period. If there is no acromioplasty, then you count the subacromial decompression towards 29823 (29822 CANNOT be billed unless it is the ONLY code being billed).

Be careful with debridement. Any debridement that is performed in preparation for a restorative procedure (RTC, tenodesis) is included with that procedure. In order to report debridement, 29823, it must be done on structures that are not repaired, basically.

There is no arthroscopic code for the nerve decompression so I would use 29999.

For shoulder coding there are two very good articles in the monthly magazines within the past two years: March 2016 & July 2017.

Thank you very much for your prompt and helpful response!

Do you have an idea of what code to compare the 29999 to?

I will definitely check those articles out!

 

[Orthocoderpgu]

Comparison code

You will have to see what they did to the nerve. My thinking is that they found where the nerve was being pinched or entrapped in scar tissue or the like, and then released the nerve. I would look at 64718 or similar codes.

If the nerve was destroyed so to speak, I would look in the 64000 series of codes for destruction of a peripheral nerve.

The comparison code will depend on what nerve procedure was performed.