AHA Coding Clinic® for HCPCS - 2018 Issue 2; Ask the Editor

Acute versus chronic rotator cuff repair

Can you help clarify the appropriate CPT code for repair of an arthroscopic rotator cuff tear that occurred from a motor vehicle accident 4 months prior to surgery? We are having a difficult time determining whether to code this repair as acute or chronic. To make this distinction, would it be appropriate to assign an unlisted arthroscopic code for this case? Some of our coding professionals feel that the repair should be coded as acute since the tear resulted from a motor vehicle accident and was not degenerative in nature. The other coding professionals feel that the injury occurred 4 months ago and therefore the repair should be coded as chronic. ...

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