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Shoulder debridement clarification needed

Charlene Posted Wed 20th of April, 2016 14:41:33 PM
I recently read a Supercoder question published Feb 28, 2012 re: extensive debridement and acromioplasty of shoulder and I would like clarification of the answer. The explanation of extensive debridement was anterior & posterior areas of glenohumeral joint or any part of glenohumeral joint and the subacromial bursa. If a decompression of the subacromial space is done and debridement of the anterior glenohumeral joint, would this be coded as extensive (29823) or 29822 with 29826? The 2016 CCI manual, musculoskeletal chapter #4 under arthroscopy states that debridement should not be reported at the same time as other procedures with in the same joint. Are we to consider the acromioclavicular joint to be a different joint from the glenohumeral joint or would these two joints be considered the same joint.
SuperCoder Answered Thu 21st of April, 2016 03:33:10 AM
Hi, 29822: For minor debridement of soft tissue, including labral debridement, cuff debridement, and so on. 29823: Either for debridement of multiple soft tissue structures (labrum, subscapularis, supraspinatus) and/or a chondroplasty of the humeral head or glenoid. For decompression of subacromial space, CPT code 29826 will be billed. Also, CPT code 29822 or 29823 (depending upon the extent of debridement performed) should be billed with modifier-59. CMS considers the shoulder joint to be a single anatomic structure so it doesn’t matter that the debridement was performed on the one or more joints or labrum. But, for billing 29823, provider should indicate that extensive debridement was performed.

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