Wiki Biceps tenotomy

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bethb

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Wow. I am finding many differences of how to code for an arthroscopic biceps tenotomy during shoulder arthroscopy. I cannot seem to make sense of it all. Or find a conclusive, agreed upon, coding solution. Does anyone have any recent and up-to-date information?

Ortho surgeon performed:

1. Left Should arthroscopy----debridement is indicated as "labral debridement with use of an arthroscopic shaver"...
2. Biceps tenotomy
3. Subacromial bursectomy--not reported separately
3. Subacromial decompression


I found that the biceps tenotomy is reportable as an unlisted CPT code along with 29822 (limited debridement) and 29826.

But then I found that the biceps tenotomy is considered to be a debridement procedure. So that, along with the labral debridement, and the subacromial bursectomy would justify 29823 (extensive debridement).

Does anyone have any suggestions on deciphering all of this? Does the biceps tenotomy, and labral debridement and subacromial bursectomy = an extensive debridement? Our surgeon is indicating in his procedure statement that shoulder arthroscopy was with "limited labral debridement".

One CPC suggests billing 29822, 29826, and 29999. Another CPC suggests billing 29823 and 29826. :( I'm the CPC unsure of herself!

Thank you all for any input or suggestions.....
 
Shoulder Surgery vs. Debridement

According to an article in AAPC Healthcare Business Monthly August 2016 "a subacromial decompression without documentation of an acromioplasty is debridement. Documentation should address changes in morphology of the acromion, and not just a skeletalization of it. Removal of osteophytes or skeletalizing the acromion is a form of debridement. Code 29823 requires that three or more areas of soft tissue are addressed and a chondroplasty of the humeral head or glenoid and associated osteophytes, or front and back of the shoulder."
 
Shoulder Surgery vs. Debridement

Also check out article "Hold Strong when shoulder Arthroscopy weighs you down" in Healthcare Business Monthly from March 2016. It states "biceps tenotomy (the removal of damaged tissue to promote healing) also meets the definition of debridement. The release of the biceps tendon allows the inflamed tissue to leave the shoulder joint and fall into the upper arm."

September 2016 Healthcare Business Monthly also had an article called "Overcome Quirky NCCI Bundling Rules for Shoulder Arthroscopy." Lots of good information in the AAPC archives.
 
This issue just popped up today. Thank you for all the relevant questions and answers.

Peace
@_^
I was able to show the doctor my copy of the March 2016 issue of HBM. Woot.
 
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