This page addresses follow-up questions and additional information pertinent to our webinar
Coding Shoulder Procedures.
** The coding information and guidance are valid at the time of publishing. Learners are encouraged to research
subsequent official guidance in the areas associated with the topic as they can change rapidly.
Q: If the surgeon documents that he repairs the supraspinatus through a scope and another through an open incision, how do you determine which one is the most extensive to decide to use open vs scope per that guideline?
A: That’s a tough call. It’s going to be based on the documentation. If it were me, I would look to see if any debridement was performed through the scope as well. If so, then in my opinion, the most extensive would have been done through the scope. When in doubt, ask your providers to give you more information as they are the only ones that know what they really did, and which was the most extensive.
Q: Which code should be used for a Bankart repair.
A: The correct CPT is 29806 if it’s done through a scope.
Q: If a provider documents that he did a repair of the supraspinatus and then does a repair of the subscapularis, can I capture CPT 29827 twice, once for each rotator cuff tendon since there are four of them and they are different tendons?
A: Unfortunately, no. we can only report 29827 one time regardless of how many rotator cuff tendons are repaired unless a patient is having a bilateral procedure.
A: Debridement of the bicep stump would be inclusive to the biceps tenodesis. The labrum would depend on the specific area of the labrum (if its at the attachment of the biceps, then we should not count it as a separate area). If it truly was a different area of the labrum then you would only be able to code 29822 for the one structure– which then bundles and not separately reportable anyhow.
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Mary Bort, CPC, CPMA, CANPC, CASCC, COSC
Consultant
Mary is a consultant for The Haugen Consulting Group with over 25 years of health care industry experience. She started her career in Orthopedics which was her passion for decades. In addition to Orthopedics, she provides expertise in other specialties such as Anesthesia, Ambulatory Surgery Center, as well as most surgical specialties . She has experience working the professional fee side of coding, audit, education as well as compliance, serving both coders and physicians, as well as the surgical side. She is a Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), Certified Anesthesia Professional Coder (CANPC) Certified Ambulatory Surgery Center Coder (CASCC) and Certified Orthopedic Surgery Coder (COSC).
During her free time, she loves to do crafts, enjoys the outdoors, and the Broncos! She has 4 daughters, and 10 grandchildren which light up her life.
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