Wiki Can 23420, 29805-59 be billed together?

sibylle

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Hello,

This is from the OP report

A posterior glenohumeral arthroscopy portal was established. The hyaline cartilages had minimal chondrosis. The biceps tendon had been ruptured. The subscapularis had tendinosis with minimal fraying in the superior third. The labrum had some mild degenerative tearing. The rotator cuff tear was apparent. The cuff tear was retracted almost to the glenoid rim on this inspection. As such, the scope was removed and a direct repair was attempted first. I decided not to do an arthroscopic decompression for fear that the cuff may not be repairable and did not want to destablize the coracoacromial ligament. The portals were closed with simple inverted 4-0 Monocryl sutures.

He then proceeds with a new incision over the lateral acromion for the rotator cuff reconstruction .

I believe, that 29805 is inclusive to the 23420. However, I haven't been able to find anything to support this. Before I approach the physician can anyone please tell me if I am correct in my assumption, and point me in the direction of supporting documentation.

I appreciate any help and thank you in advance for your time

Sibylle
 
AAOS' April 2004 Bulletin states :

"As with all arthroscopic procedures, code 29805 (Arthroscopy, shoulder, diagnostic with or without synovial biopsy) is reported only when nothing else is done. If any other code is used, it is not appropriate to report the diagnostic code, even if the diagnostic arthro- scopy is followed by an open procedure. If an arthroscopic procedure is followed by an open procedure, the diagnostic procedure cannot be used and only the code for the open procedure can be reported."


http://www2.aaos.org/bulletin/aug05/coding.asp
 
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