Wiki Shoulder arthroscopy's

[kathy a]

Patient had a Mumford procedure-# 29824 with subacromial decompression # 29826. He also had an intra articular debridement of a flap tear? Not sure on this one?Any help would be greatly appreciated.
Kathy

 

[nyyankees]

Patient had a Mumford procedure-# 29824 with subacromial decompression # 29826. He also had an intra articular debridement of a flap tear? Not sure on this one?Any help would be greatly appreciated.
Kathy

where was the debridement? If it was separate from 29824 and 29826 look at 29822-59. But if it's a Medicare patient or carrier that follows CMS edits you won't be able to capture.

 

[kathy a]

Here are his surgical notes.

I began by making a standard posterolateral viewing portal into the shoulder.The arthroscope was introduced into the shoulder joint and the joint was insufflated.Diagnostic arthroscopy was carried out and findings were as follows.He had a partial articular sided supraspinatus tear noted with some articular sided fraying.He had some degenerative fraying at the biceps anchor as well as the labrum and around the 12 oclock position.Subscapularis was intact.Articular surface was intact without any significant arthritic changes and the axillary pouch was free of foreign body.At this point I then proceeded to make an anterior portal for intrarticular treatment utilizing a switching stick technique.An anterior portal was established and the arthroscopic shaver was introduced through this.I began by debrided the biceps anchor and labrum.The debridement was carried back to stable edge.The biceps anchor was probed and found to be intact and stable.I then turned my attention to the rotator cuff.The articular sided frame was debrided with an arthroscopic shaver back to a stable edge. After a thorough debridement the cuff anchor was inspected and found to be in good condition and it was felt it was only less than 20% of the tendinosis thickness.At this point I evacuated the shoulder joint. The scope was withdrawn and redirected to the subacromial space.A lateral portal was established.A significant amount of hemorrhagic bursitis was encountered in the subacromial space. This was debrided in order for visualization.The subacromial region was identified. He had a large downward projecting spur. Utilizing the arthroscopic bur subacromial decompression was completed as far medial as the AC joint.This opened up the subacromial space very nicely.I was able to visualize the distal end of the clavicle which showed endstage arthritic changes and spur formation. I then carried out a Mumford procedure utilizing the arthroscope bur by redirecting my anterior portal up into the AC joint and the arthroscopic bur was introduced here for resection of the distal clavicle.After complete resection of the distal clavicle I the turned my attention back to the rotator cuff.
The bursectomy was completed on the rotator cuff side down into the lateral gutter.After a complete debridement of the bursitis the rotator cuff was visualized.I used a probe to feel the rotator cuff in its insertion and no tears or rents were found and no repair was deemed necessary. At this point I proceeded with closure.

Hope this helps. I coded the # 29824 and # 29826. I wasn't sure of anything else? Thanks for your help. Kathy

 

[nyyankees]

Here are his surgical notes.

I began by making a standard posterolateral viewing portal into the shoulder.The arthroscope was introduced into the shoulder joint and the joint was insufflated.Diagnostic arthroscopy was carried out and findings were as follows.He had a partial articular sided supraspinatus tear noted with some articular sided fraying.He had some degenerative fraying at the biceps anchor as well as the labrum and around the 12 oclock position.Subscapularis was intact.Articular surface was intact without any significant arthritic changes and the axillary pouch was free of foreign body.At this point I then proceeded to make an anterior portal for intrarticular treatment utilizing a switching stick technique.An anterior portal was established and the arthroscopic shaver was introduced through this.I began by debrided the biceps anchor and labrum.The debridement was carried back to stable edge.The biceps anchor was probed and found to be intact and stable.I then turned my attention to the rotator cuff.The articular sided frame was debrided with an arthroscopic shaver back to a stable edge. After a thorough debridement the cuff anchor was inspected and found to be in good condition and it was felt it was only less than 20% of the tendinosis thickness.At this point I evacuated the shoulder joint. The scope was withdrawn and redirected to the subacromial space.A lateral portal was established.A significant amount of hemorrhagic bursitis was encountered in the subacromial space. This was debrided in order for visualization.The subacromial region was identified. He had a large downward projecting spur. Utilizing the arthroscopic bur subacromial decompression was completed as far medial as the AC joint.This opened up the subacromial space very nicely.I was able to visualize the distal end of the clavicle which showed endstage arthritic changes and spur formation. I then carried out a Mumford procedure utilizing the arthroscope bur by redirecting my anterior portal up into the AC joint and the arthroscopic bur was introduced here for resection of the distal clavicle.After complete resection of the distal clavicle I the turned my attention back to the rotator cuff.
The bursectomy was completed on the rotator cuff side down into the lateral gutter.After a complete debridement of the bursitis the rotator cuff was visualized.I used a probe to feel the rotator cuff in its insertion and no tears or rents were found and no repair was deemed necessary. At this point I proceeded with closure.

Hope this helps. I coded the # 29824 and # 29826. I wasn't sure of anything else? Thanks for your help. Kathy

You can capture 29822-59 for the RC debridement.

 

[kathy a]

Thanks for your help!