Wiki Posterior capsulolabral reconstruction

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dlambert12005@yahoo.com

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Good afternoon,
I have a coding situation that I need some assistance with. Does anyone know the cpt code for a posterior capsulolabral reconstruction? I'm thinking I may need to use an unlisted code 29999 but I also see some 29806 for the posterior. Any suggestions would be greatly appreciated.
Thanks
Donna
 
Divide the shoulder correctly

When Dr. William Beach created these codes, he wanted to divide the shoulder into an upper half and lower half and assigned code 29807 for the top and 29806 for the bottom.

This is where the clocking positions come in handy. This way the coder knows which code to assign. Find out where the tear is located, top or bottom in order to determine your code.
 
Thank you for your response.

I was thinking just like you and was using 29807 initially but when my doctor said he spoke with another doctor at an insurance co and he told him that 29807 was strictly for a SLAP not a posterior capsulolabral reconstruction. That's why I'm just at a lost on this one.
 
Don't let insurance companies throw you off

If the repair is in the Posteriorsuperior section of the shoulder it sure is.

Don't be lost on this one, William Beach MD divided the shoulder differently, upper and lower not anterior/posterior.

I worked for a large national insurance company for several years. The physician they hired to answer medical questions had been retired for several years and answered questions on all specialties. My guess is that the physician your doctor spoke to was not an orthopedic surgeon. More likely an internal medicine physician.
 
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