AHA Coding Clinic® for HCPCS - 2018 Issue 1; Ask the Editor

Multiple shoulder procedures

The guidance published in First Quarter 2015, Coding Clinic for HCPCS, Question & Answer #1, Page 7, specifically states that the primary procedure was performed on the shoulder which is a single structure and that the other procedures performed on the same structure would not be reported separately. It further goes on to state that, no additional code would be reported for the tendon debridement and the other arthroscopic procedures performed, as they’re considered inherent to the open rotator cuff repair. However, we’ve encountered some additional clarification with NCCI edit information 2017- such as Shoulder arthroscopy procedures include limited debridement (e.g., CPT code 29822) even if the limited debridement is performed in a different area of the same shoulder than the other procedure. With three exceptions, shoulder arthroscopy procedures include extensive debridement (e.g., CPT code 29823) even if the extensive debridement is performed in a different area of the same shoulder than the other procedure. CPT codes 29824 (arthroscopic claviculectomy including distal articular surface), 29827 (arthroscopic rotator cuff repair), and 29828 (biceps tenodesis) may be reported separately with CPT code 29823 if the extensive debridement is performed in a different area of the same shoulder. Can you provide some clarification of this issue? ...

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