Wiki debribement of the labrum-29822

[debmorrison]

Hello all,

I am having a very tough time getting insurance cos (especially BCBS) to reimburse for an arthroscopic debridement of the labrum (using 29822-59) when billed in conjunction with other shoulder arthroscopy codes. (ex:29827, 29826).
I am confident that we are billing correctly and have documentation in the op notes to support it. But I can't seem to get through to them.
Can anyone give me some insight as to how you fight your denials, maybe some supporting literature to send?

Thanks much!
Debbie

 

[mitchellde]

does your op note show that this in in a separate compartment of the shoulder? Is the debridement documented as a procedure that is therapeutic or is it it performed as a procedure that allows easyier movement of the scope? Some payers will not allow payment if the note does not clearly show therapeutic value. Also if there is no documentation of a separate compartment then you cannot appent the 59.