CJoy0724
Networker
Hey everyone, I have a physician who states he did an "arthroscopic reconstruction of a greater tuberosity nonunion". In the op report, he lists Arthroscopic excision greater tuberosity nonunion and Arthroscopic double row rotator cuff repair. I'm not really sure how to code this. There is no code for repair of a nonunion or "excision" of the non-union, and reading the op note it almost reads like just a rotator cuff repair. Here is part of the op note:
There was no obvious full thickness defect in the cuff. Using our marking PDS suture as a guide as well as her preoperative MRI and plain films, we did continue to remove bursa over the greater tuberosity in a more anterior direction. This did eventually allow identification of the fracture site and bed. She had what appeared to be an impacted component of about 1 x 1 centimeter. This did not have any appreciated cuff tissue attached to it. The fragment was then elevated. This revealed a very small cortical wafer that was not felt to be viable. We did curet out her bed and cancellous surface of all scar tissue of which there was a fair amount. We then completed her partial thickness tear using a Beaver blade. A single Mitek helix anchor was then inserted into the bone within the bed. This was double loaded with Orthocord suture. We subsequently passed this in a horizontal mattress fashion through the supraspinatus. These horizontal mattress sutures
were then tied down with alternating half hitches. Lateral row fixation was
then achieved in a cross bridge type fashion using 2 Arthrex 3.5 mm push lock
Peek anchors.
I am leaning towards just 29827 for this portion, but can I bill anything for the treatment of the nonunion?
Thanks!
Chrissy
There was no obvious full thickness defect in the cuff. Using our marking PDS suture as a guide as well as her preoperative MRI and plain films, we did continue to remove bursa over the greater tuberosity in a more anterior direction. This did eventually allow identification of the fracture site and bed. She had what appeared to be an impacted component of about 1 x 1 centimeter. This did not have any appreciated cuff tissue attached to it. The fragment was then elevated. This revealed a very small cortical wafer that was not felt to be viable. We did curet out her bed and cancellous surface of all scar tissue of which there was a fair amount. We then completed her partial thickness tear using a Beaver blade. A single Mitek helix anchor was then inserted into the bone within the bed. This was double loaded with Orthocord suture. We subsequently passed this in a horizontal mattress fashion through the supraspinatus. These horizontal mattress sutures
were then tied down with alternating half hitches. Lateral row fixation was
then achieved in a cross bridge type fashion using 2 Arthrex 3.5 mm push lock
Peek anchors.
I am leaning towards just 29827 for this portion, but can I bill anything for the treatment of the nonunion?
Thanks!
Chrissy