Wiki Shoulder scope and modifiers

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kellit21

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Ok, so I am full of questions today!!

Patient had a Right shoulder scope with extensive debridement
Distal Clavical Resection
Subacromial Decompression

29823, 29824, and 29826 ... what modifier would you use and on which code?
 
kellit21 said:
Ok, so I am full of questions today!!

Patient had a Right shoulder scope with extensive debridement
Distal Clavical Resection
Subacromial Decompression

29823, 29824, and 29826 ... what modifier would you use and on which code?
Click to expand...

Was the extensive debridement om multiple soft tissue (i.e labrum, biceps) unrelated to 29824 and 29826? If so I would submit the 3 codes w/o a modifier.
 
I would agree with the above information for commercial carriers that do not follow MCR rules. The 29822 would be billable even if you had different diagnosis for the procedures.

Medicare patients: NCCI Guidelines state (effective 1/1/2013:
CMS considers the shoulder joint to be a single anatomic structure. An NCCI procedure to procedure edit code pair consisting of two codes describing two shoulder joint procedures should never be bypassed with an NCCI-associated modifier when performed on the ipsilateral shoulder joint. This type of edit may be bypassed only if the two procedures are performed on contralateral joints.
 
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