codemeister
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I have a question about how to report codes for an assistant (such as a PA) for an arthroscopic shoulder capsulorrhaphy. For example, if the operative session consists of the capsulorrhaphy (29806), extensive debridement (29823) and a subacromial decompression with partial acromioplasty (+29826), billing and bundling situations apply.
The 29823 is bundled into the 29806, so for the primary surgeon the coding would be 29806 followed by 29826.
However, for the assistant, the billing gets complicated, because 29806 is not reportable by the assistant. This is because, according to the MPFS, 29806 is classified as an "Assistant at Surgery Status 1 Indicator" code which to the best of my understanding and those in my professional circle means that it's inappropriate to bill this code for the assistant regardless of the payer. Since the debridement is bundled into the Bankart repair, and 29826, which is not bundled, is just an add-on code, how do we report the assistant's services?
I've gotten suggestions that range from reporting the Bankart (29806) anyway with the SAD (29826) just as with the primary surgeon, to reporting 29823 followed by 29826 since the debridement work was done and the assistant would get credit for it, to reporting nothing at all since you can't report an add-on code alone.
Any thoughts or referrals to documentation on this specific subject welcome!
The 29823 is bundled into the 29806, so for the primary surgeon the coding would be 29806 followed by 29826.
However, for the assistant, the billing gets complicated, because 29806 is not reportable by the assistant. This is because, according to the MPFS, 29806 is classified as an "Assistant at Surgery Status 1 Indicator" code which to the best of my understanding and those in my professional circle means that it's inappropriate to bill this code for the assistant regardless of the payer. Since the debridement is bundled into the Bankart repair, and 29826, which is not bundled, is just an add-on code, how do we report the assistant's services?
I've gotten suggestions that range from reporting the Bankart (29806) anyway with the SAD (29826) just as with the primary surgeon, to reporting 29823 followed by 29826 since the debridement work was done and the assistant would get credit for it, to reporting nothing at all since you can't report an add-on code alone.
Any thoughts or referrals to documentation on this specific subject welcome!