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Shoulder Arthroscopic Debridement ASC Coding

Camille Posted Fri 07th of February, 2020 12:58:10 PM
Performed: Arthroscopic Rotator Cuff Repair (29827), Biceps Tenodesis (29828), Distal Claviculectomy (29824), and Subacromial Decompression (add-on code/not billable in ASC). Provider also performed multiple light debridements (of); supraglenoid tubercle, posterior labrum, anterior labrum, subscapularis (aggressive debridement during RCR), bursa (overlying the RC), hypertrophic bursal tissue in the subacromial space. QUESTION: Is it appropriate for me to code also CPT 29823 for the multiple debridements? Thank you, kindly!
SuperCoder Answered Mon 10th of February, 2020 03:34:40 AM

Hi Camille,

 

It would be appropriate to bill CPT code 29823 for multiple debridements. Your operative note should clearly document that debridement was performed at labrum (posterior and anterior), subscapularis, supraglenoid tubercle, bursa and subacromial space on the billed date of service. Kindly bill in the below mentioned manner:

 

  • 29827
  • 29828-51
  • 29824-51
  • 29823-51

 

Thanks!

 

  

Camille Posted Mon 10th of February, 2020 12:09:36 PM
Thank you very much! How much debridement must there be before coding 29823?
SuperCoder Answered Tue 11th of February, 2020 02:52:15 AM

Hi Camille,

 

Code 29822 covers limited debridement of soft or hard tissue and should be used for limited labral debridement, cuff debridement, or the removal of degenerative cartilage and osteophytes.

 

Code 29823 should be used only for extensive debridement of soft or hard tissue. It includes a chondroplasty of the humeral head or glenoid and associated osteophytes, or multiple soft tissue structures that are debrided such as labrum, subscapularis and supraspinatus.

 

 

Also, per American Academy of Orthopedic Surgeons (AAOS), limited debridement (29822) would consist of work done in just a portion of the shoulder, such as the front or the back of the shoulder. To support extensive debridement (29823), the documentation should support work in BOTH the front and back of the shoulder.

 

Debridement in a single area or compartment would qualify as limited, while debridement in multiple locations/compartments of the shoulder joint support coding for extensive debridement.

 

Thanks!

 

 

 

Camille Posted Tue 11th of February, 2020 12:25:48 PM
Great info, thank you!
SuperCoder Answered Tue 11th of February, 2020 23:41:40 PM

Thank you, happy to help.

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