Charlene Posted Thu 11th of April, 2019 16:59:57 PM
SHOULDER ARTHROSCOPY PERFORMED WITH DISTAL CLAVICULECTOMY (29824) DUE TO OA, SUBACROMIAL DECOMPRESSION (29826) FOR IMPINGMENT SYNDROME. MY QUESTION IS: WILL BURSECTOMY FOR DECOMPRESSION OF SUBACROMION AND DEBRIDEMENT OF LABRAL TEAR JUSTIFY EXTENSIVE DEBRIDEMENT ( 29823)? UPON QUERY, THE PROVIDER "PERFORMED BURSECTOMY FOR IMPINGMENT AS IS ALWAYS DONE WITH DECOMPRESSION". WITHOUT ANOTHER DX, SUCH AS BURSITIS, WOULD USING IMPINGEMENT SYNDROME AGAIN ALONG WITH SUPPORT 29823?
Charlene Posted Thu 11th of April, 2019 17:33:15 PM
Please provide guidelines from AAOS or other group to correlate with response. Thank you
SuperCoder Answered Fri 12th of April, 2019 05:04:51 AM
You should report 29826 to cover the surgeon's work performing the subacromial decompression and the bursectomy.
If the surgeon performed the debridement of the labral tear in the gleno-humeral space, you should report either 29822 (Arthroscopy, shoulder, surgical; debridement, limited) or 29823 (... debridement, extensive), depending on the extent of the debridement that the surgeon documented.
If the surgeon performed the labral tear debridement in the subacromial space, you cannot separately report a debridement code because the service is included in the reimbursement for 29826. As per the guidelines, the limited débridement code (29822) is included with the other, more extensive arthroscopic procedure codes.
It is appropriate to using impingement syndrome again along with support 29823, if operative report justify the medical necessity.
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