Forum - Questions & Answers

May 15th, 2013 - BONE 16 

Billing procedure code 29826

Thanks for answering my question.

I do have another question my Doctor did a decompression of subacromial proc code 29826 as #1 proc. code and the scpoe distal clav. proc. code 29824 as the #2 procedure adding a 51 modifier.
The 29826 is now an add on code . How can I bill these two procedure to bwc workerscomp. or does he have to use another proc. code for the 29826

Thanks in advance

May 15th, 2013 - Orthomom 23 

re: BILLING PROCEDURE CODE 29826

29826 can never be billed as the primary procedure. The distal clavicle resection (29824) has to be listed as the primary. Using a different procedure code for the 29826 would be considered inappropriate billing.

May 15th, 2013 - agent00711   151 

re: BILLING PROCEDURE CODE 29826

CPT® 29826 (Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with or without coracoacromial release) has been deemed an add on code for 2012 and may be billed with the below listed CPT® codes as the primary CPT® code meaning they simple need to be listed first. Because this code has been deemed an add on, it may no longer be billed as a standalone code. In the event an ASAD is performed as an isolated procedure, it will need to be reported as an unlisted CPT® code 29999 (unlisted procedure arthroscopy).

CPT® 29806 - Arthroscopy, shoulder, surgical; capsulorrhaphy
CPT® 29807 - Arthroscopy, shoulder, surgical; repair of SLAP lesion
CPT® 29819 - Arthroscopy, shoulder, surgical; with removal of loose body or foreign body
CPT® 29820 - Arthroscopy, shoulder, surgical; synovectomy, partial
CPT® 29821 - Arthroscopy, shoulder, surgical; synovectomy, complete
CPT® 29822 - Arthroscopy, shoulder, surgical; debridement, limited
CPT® 29823 - Arthroscopy, shoulder, surgical; debridement, extensive
CPT® 29824 - Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (Mumford procedure)
CPT® 29825 - Arthroscopy, shoulder, surgical; with lysis and resection of adhesions, with or without manipulation.

Primary procedures include but are not limited to arthroscopic rotator cuff repairs, arthroscopic debridements (the debridement would be performed on an area separate/distinct and unrelated to the work performed for the decompression) or an arthroscopic claviculectomy. It is imperative that documentation detail all work performed in every area/region of the shoulder. Describe all tendons, muscles, tears (types), defects and anatomical areas in which work was performed and all techniques/methods (i.e. debridement, repair, excisions and/or releases).



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