AT2728
Expert
I have another arthroscopic shoulder procedure I'm struggling with. I'm trying to grasp the whole 29826/29823 use and I'm just not there yet. Your assistance would be greatly appreciated...and any suggestion for how to understand this would be helpful!
I was thinking 29827 and 29826--Would I code 29999 for bicep tenotomy or 29823?
POSTOPERATIVE DIAGNOSIS:
1. Right shoulder rotator cuff tear.
2. Right shoulder biceps tendonitis.
3. Right shoulder labral tear.
4. Right shoulder osteoarthritis.
PROCEDURE PERFORMED:
1. Right shoulder arthroscopic rotator cuff repair.
2. Right shoulder biceps tenotomy.
3. Right shoulder subacromial decompression.
4. Right shoulder labrum debridement.
...... Diagnostic arthroscopy of the right shoulder ensued.
The patient had a tear of the supraspinatus tendon. There were no loose bodies. The patient had grade III chondromalacia of the glenoid. He also had a labral tear and a partial tear of the biceps tendon with biceps tendonitis. At this point in time, the anterior portal was made. A biceps tenotomy was performed and a labral debridement was performed. At this point in time, the arthroscope was brought into the subacromial space. The lateral portal was established. A bursectomy was performed. Soft tissue was removed on the undersurface of the acromion. Once this was done, using the bur, subacromial decompression was performed converting a type II acromion to a type I. At this point in time, the rotator cuff was viewed. He had an abundant amount of bursal tissue. It appeared very friable. At this point in time, a repair was made. 2-0 orthocord was placed using marginal convergence technique bringing the anterior and posterior leaflets together. A Mitek helix anchor 5.5 mm was placed at the dead man's angle of the humerus. Several attempts were made until finally the suture did hold through the rotator cuff. As stated, the rotator cuff was very friable. The sutures were then all tied down in an arthroscopic sliding knot. Once this was done, the shoulder was moved and the humerus and rotator cuff moved as one unit. At this point in time, the shoulder was drained of the fluid. 3-0 nylon suture was used to close the skin.
I was thinking 29827 and 29826--Would I code 29999 for bicep tenotomy or 29823?
POSTOPERATIVE DIAGNOSIS:
1. Right shoulder rotator cuff tear.
2. Right shoulder biceps tendonitis.
3. Right shoulder labral tear.
4. Right shoulder osteoarthritis.
PROCEDURE PERFORMED:
1. Right shoulder arthroscopic rotator cuff repair.
2. Right shoulder biceps tenotomy.
3. Right shoulder subacromial decompression.
4. Right shoulder labrum debridement.
...... Diagnostic arthroscopy of the right shoulder ensued.
The patient had a tear of the supraspinatus tendon. There were no loose bodies. The patient had grade III chondromalacia of the glenoid. He also had a labral tear and a partial tear of the biceps tendon with biceps tendonitis. At this point in time, the anterior portal was made. A biceps tenotomy was performed and a labral debridement was performed. At this point in time, the arthroscope was brought into the subacromial space. The lateral portal was established. A bursectomy was performed. Soft tissue was removed on the undersurface of the acromion. Once this was done, using the bur, subacromial decompression was performed converting a type II acromion to a type I. At this point in time, the rotator cuff was viewed. He had an abundant amount of bursal tissue. It appeared very friable. At this point in time, a repair was made. 2-0 orthocord was placed using marginal convergence technique bringing the anterior and posterior leaflets together. A Mitek helix anchor 5.5 mm was placed at the dead man's angle of the humerus. Several attempts were made until finally the suture did hold through the rotator cuff. As stated, the rotator cuff was very friable. The sutures were then all tied down in an arthroscopic sliding knot. Once this was done, the shoulder was moved and the humerus and rotator cuff moved as one unit. At this point in time, the shoulder was drained of the fluid. 3-0 nylon suture was used to close the skin.