Desperate Denise
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I really need your help with this - -
I must have missed something at the last coding course I went to cuz the insurance carriers are killing me with inquiries and takebacks on my shoulders.
I get hung up on the back to front thing with the 29823 code and then deciding when I can bill the 29826 with 29822 or 29823 - I am fearful of unbundling. Then the modifier 59 vs 51 - I need a meeting desperately.
PLEASE HELP!!!
THANK YOU SOOOOOOOOOOO MUCH!!
Here is the op-note:
PREOPERATIVE DIAGNOSIS: Left shoulder labral tear.
POSTOPERATIVE DIAGNOSES:
1. Left shoulder labral tear.
2. Rotator cuff tear.
3. Impingement syndrome.
OPERATION PERFORMED: Left shoulder arthroscopy. Rotator cuff debridement.
Labral debridement. Arthroscopic bursectomy with subacromial
decompression.
INDICATIONS FOR PROCEDURE:The patient is a 36 year old who has pain in
his left shoulder who has failed conservative measures. The risks and
benefits of the surgery were discussed with the patient including
bleeding, infection, nerve or artery damage, failure to improve his pain,
need for further surgery, and he wishes to proceed.
DESCRIPTION OF PROCEDURE:The patient was brought to the operating room and placed supine on the operating room table. After induction of general anesthetic and an interscalene block, he was placed in the beach chair position. All bony prominences were padded. His left shoulder was
prepped and draped in a standard surgical fashion. An inferolateral
portal was created. The examination of the joint showed normal
subscapularis tendon, normal glenohumeral articular surfaces. There was a
type 1 tear of the superior labrum. The biceps tendon was intact. There
was a 10% tear of the supraspinatus. There was 3 mm of greater tuberosity
showing.
The 3.5 mm full radius shaver was used to perform a rotator cuff
debridement and a labral debridement. The posterior labrum was intact.
The inferior capsule was intact. The attention was then directed to the
subacromial space where a subacromial decompression was carried out.
There was a significant spur anteriorly. The rotator cuff was intact from
above. The shoulder was irrigated, and the portals were closed with 4-0
monocryl.
I must have missed something at the last coding course I went to cuz the insurance carriers are killing me with inquiries and takebacks on my shoulders.
I get hung up on the back to front thing with the 29823 code and then deciding when I can bill the 29826 with 29822 or 29823 - I am fearful of unbundling. Then the modifier 59 vs 51 - I need a meeting desperately.
PLEASE HELP!!!
THANK YOU SOOOOOOOOOOO MUCH!!
Here is the op-note:
PREOPERATIVE DIAGNOSIS: Left shoulder labral tear.
POSTOPERATIVE DIAGNOSES:
1. Left shoulder labral tear.
2. Rotator cuff tear.
3. Impingement syndrome.
OPERATION PERFORMED: Left shoulder arthroscopy. Rotator cuff debridement.
Labral debridement. Arthroscopic bursectomy with subacromial
decompression.
INDICATIONS FOR PROCEDURE:The patient is a 36 year old who has pain in
his left shoulder who has failed conservative measures. The risks and
benefits of the surgery were discussed with the patient including
bleeding, infection, nerve or artery damage, failure to improve his pain,
need for further surgery, and he wishes to proceed.
DESCRIPTION OF PROCEDURE:The patient was brought to the operating room and placed supine on the operating room table. After induction of general anesthetic and an interscalene block, he was placed in the beach chair position. All bony prominences were padded. His left shoulder was
prepped and draped in a standard surgical fashion. An inferolateral
portal was created. The examination of the joint showed normal
subscapularis tendon, normal glenohumeral articular surfaces. There was a
type 1 tear of the superior labrum. The biceps tendon was intact. There
was a 10% tear of the supraspinatus. There was 3 mm of greater tuberosity
showing.
The 3.5 mm full radius shaver was used to perform a rotator cuff
debridement and a labral debridement. The posterior labrum was intact.
The inferior capsule was intact. The attention was then directed to the
subacromial space where a subacromial decompression was carried out.
There was a significant spur anteriorly. The rotator cuff was intact from
above. The shoulder was irrigated, and the portals were closed with 4-0
monocryl.