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Excison of AC menisus of shoulder

Teresa Posted Wed 02nd of March, 2016 20:46:28 PM

What would the cpt code be for open excision of a degenerative can meniscus of the shoulder be?

SuperCoder Answered Thu 03rd of March, 2016 08:37:30 AM

Hi Teresa,
Please provide more information of the procedure so that we can give the exact CPT code in this case. Thanks.

Teresa Posted Mon 07th of March, 2016 22:32:56 PM

An incision was made in the direction of the clavicle, opening the anterior capsule of the AC joint, reflecting the capsule of the AC joint. We then removed the AC meniscus. We then resected the distal clavicle, approximately just under half and inch.

SuperCoder Answered Tue 08th of March, 2016 06:52:39 AM

Use code 23420-52 modifier for AC removal and 23120 for resection of distal clavicle.

Teresa Posted Tue 08th of March, 2016 12:25:02 PM

Why wouldn't I look at cpt code 23101 for excision of the ac meniscus?

SuperCoder Answered Wed 09th of March, 2016 06:34:36 AM

As per documentation, the procedure performed above is little complex where the AC meniscus is removed along with resection of distal clavicle, for which provider makes an incision and opens anterior capsule to reach AC joint, so the appropriate code to bill will be 23420-52. Whereas CPT 23101 involves Arthrotomy, acromioclavicular joint for excision of torn cartilage, which can be simple labrum tear.
To provide you with more explanation, please provide some more details regarding the procedure performed.

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