Wiki Change in NCCI edit 29823 October 1

[betsycpcp]

I just noticed that with the quarterly changes effective October 1, 2022, 29823 is now showing up as a column 2 code for 29827 and 29828. Ever since 2017, the NCCI Policy Manual has said that extensive debridement can be reported w/ 29824, 29827, and 29828 if done in a different area of the same shoulder, and the edit tables had a termination date of 6/30/16 for all 3 codes. As of 10/1/22 they have removed the termination date from 29827 and 29828 (it's still there for 29824). Does anyone know why the edits changed? I can't find anything except for lists of the changes.

 

[nickelclaw]

https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd

from coding clinic 4th quarter 2020 pg 11-13
Arthroscopy

A diagnostic arthroscopy is inherent to a surgical arthroscopy and is not separately reported. This includes diagnostic arthroscopies that lead to a surgical arthroscopy during the same encounter and "scout" arthroscopies performed to assess the surgical field or extent of the disease.

When a surgical arthroscopic procedure is converted to an open procedure, only the open procedure is reported. This pertains to both surgical and diagnostic arthroscopic procedures.

In general, arthroscopic debridement is not separately reported with surgical arthroscopy when performed on the same joint. However, there are guidelines specific to debridement of the knee and shoulder as follows:

The exception to the debridement guideline for the knee, for Medicare beneficiaries, includes reporting HCPCS Level II code G0289, Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee, if the documentation supports removal of a loose body or foreign body from a different compartment of the same knee. HCPCS code G0289 may not be reported when performed on the same compartment.

Limited shoulder debridement (CPT code 29822, Arthroscopy, shoulder, surgical; debridement, limited), is included in shoulder arthroscopic procedures and may not be separately reported. This includes debridement that occurs in a different area of the same shoulder. Extensive shoulder debridement (CPT code 29823, Arthroscopy, shoulder, surgical; debridement, extensive), is also not reported with surgical arthroscopy even when performed in different areas of the same shoulder. However, there are three exceptions related to extensive debridement and when it may be additionally reported: 1) with arthroscopic claviculectomy, 2) with biceps tenodesis, and 3) with arthroscopic rotator cuff repair, ONLY when the extensive debridement is performed in a different area of the same shoulder.

 

[nickelclaw]

from the NCCI edit 29823 for 01/01/2022
7. Shoulder arthroscopy procedures include limited debridement (e.g., CPT code 29822) even if the limited debridement is performed in a different area of the same shoulder than the other procedure. With 3 exceptions, shoulder arthroscopy procedures include extensive debridement (e.g., CPT code 29823) even if the extensive debridement is performed in a different area of the same shoulder than the other procedure. CPT codes 29824 (Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (Mumford procedure)), 29827 (Arthroscopy, shoulder, surgical; rotator cuff repair), and 29828 (Arthroscopy, shoulder, surgical; biceps tenodesis) may be reported separately with CPT code 29823 if the extensive debridement is performed in a different area of the same shoulder.

The last sentence was updated this year

 

[betsycpcp]

Thanks Nichole -- I saw where the manual had that section updated - but all they did was replace shortened code descriptions with the full descriptions. I know they only publish the manual once a year, so if there is a change effective October 1st it won't be addressed in the manual. So I was wondering if anyone has seen the rationale for changing the edits with 29827 and 29828 as of 10/1.