Wiki is an arthroscopic biceps tenotomy inclusive to extensive debridement

Create Wiki
J

jrburke

New
Messages
9
Location
Kirkland
Best answers
0
We were just told by our State Labor and Industries review department for prior authorization (Qualis) that per AAPC Coding guidelines, and arthroscopic biceps tenotomy (CPT 29999 compared to 23405) is inclusive to an arthroscopic debridement (29823), however, according to AAOS, these are not inclusive codes as well as looking at the NCCI guidelines Ch 4 section E subsection 7 -

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 three 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 (arthroscopic claviculectomy including distal articular surface), 29827 (arthroscopic rotator cuff repair), and 29828 (biceps tenodesis) may be reported separately with CPT code 29823 if the extensive debridement is performed in a different area of the same shoulder.

There were 2 separate arthroscopic portals made one was posterior and then once tenotomy was complete scope was removed and an lateral acromial anterior portal was made.

Can someone tell me where this guidelines is... as I now have conflicting information.

Thank you in advance!!!!
 
According to Coding Clinic, the arthroscopic tenotomy is considered inherent to CPT 29822 and 29823 and would not be reported separately.

Rotator cuff repair and debridement with biceps tenotomy
Coding Clinic for HCPCS - Second Quarter 2013 Page: 7,8

QUESTION 5

The patient presents with a full-thickness rotator cuff tear, subacromial impingement, degenerative joint disease (DJD), and near full-thickness rupture of the long head of the biceps. Patient undergoes arthroscopic rotator cuff repair, acromioplasty, chondroplasty of the humeral head and biceps tenotomy. A shaver was inserted at the anterior portal and the rotator cuff tear (supraspinatus) was debrided and chondroplasty of the humeral head was performed. A radial cautery device was utilized to perform a biceps tenotomy. A Type 2 acromion was noted and a radio frequency wand and bur were used for the acromioplasty, and the coracoacromial ligament was removed. Through lateral portals, the entirely torn supraspinatus was retracted to the glenihumeral joint and the rotator cuff was repaired with anchor devices and sutures. The biceps tenotomy was performed for a biceps rupture and not for debridement or part of the rotator cuff repair. Based on this operative report, is the arthroscopic biceps tenotomy inherent with the rotator cuff repair (29827), part of the debridement (29822-29823), or would it be separately reported (29999)?

ANSWER

The arthroscopic tenotomy is considered inherent to CPT code 29822, Arthroscopy, shoulder, surgical; debridement, limited, and CPT code 29823, Arthroscopy, shoulder, surgical; debridement, extensive, and would not be reported separately. Reporting of CPT codes 29822 or 29823 would be dependent on the extent of the debridement.
Click to expand...
 
And...

If a biceps tenodesis is performed, the biceps tenotomy would be included in that procedure and not count towards 29823.

Please see the 2017 CMS NCCI surgical policy update which outlines the proper use of 29823 since it can only be reported with 29824, 29827 & 29828 and cannot be related to a repair procedure.
 
You must log in or register to reply here.
Top