Wiki Arthroscopy w/bursa removal??

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rubybluemonkey

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I need help coding the following, my provider and I disagree. THANKS!

Procedure: Arthoscopy, left shoulder. Subacromial decompression, left shoulder. Acromioplasty, left shoulder.

Diagnostic arthroscopy was undertaken as noted above. The standard anterior portal was made using an outside-in technique. The synovitis was removed using the low setting on the Stryker surface wand. The scope was then withdrawn and placed in the subacrominal space and the bursa was removed as was the scar tissue and coacoacromial ligament from the undersuface of the acromion. The superior surface of the rotator cuff was then evaluated and found to be intact. The acromion was then flattened using the bur. The scope was withdrawn from the posterior portal and placed in the lateral portal and the bur was brought in posteriorly. The anterior acromion was then taken out and the shoulder was flushed.
 
rubybluemonkey said:
I need help coding the following, my provider and I disagree. THANKS!

Procedure: Arthoscopy, left shoulder. Subacromial decompression, left shoulder. Acromioplasty, left shoulder.

Diagnostic arthroscopy was undertaken as noted above. The standard anterior portal was made using an outside-in technique. The synovitis was removed using the low setting on the Stryker surface wand. The scope was then withdrawn and placed in the subacrominal space and the bursa was removed as was the scar tissue and coacoacromial ligament from the undersuface of the acromion. The superior surface of the rotator cuff was then evaluated and found to be intact. The acromion was then flattened using the bur. The scope was withdrawn from the posterior portal and placed in the lateral portal and the bur was brought in posteriorly. The anterior acromion was then taken out and the shoulder was flushed.
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Interesting. The bursectomy would be inclusive of acromioplasty (29826). But there was a debridement of synovitis that could support 29822 (Debridement, limited). Since 29826 is an add-on code you could report 29826 + 29822. But many carriers (except Medicare) still consider 29826 a primary procedure. Who is the carrier? If Medicare report 29823 for all but if Oxford/UHC I'd report 29826 + 29822-59. Good luck.
 
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