Hi,
I need help on this one. I received a denial on 29826 59.
Procedures performed: 1. Left shoulder arthroscopy with subacromial decompression. 2. Acriomioplasty. 3. Bicepts tenotomy. 4. Rotator cuff repair, mini open. 5. Distal clavicle excision, open.
Payor is telling me 29826 is an add on code to another procedure.
This is how I billed:
23412 Lt
23405 59
23120 59
29826 59
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on "Add on code 29826 denial"
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on "Add on code 29826 denial"
When your surgeon performs an arthroscopic subacromial decompression as the only procedure, you may turn to codes 29822 or 29823, depending upon whether your surgeon does a limited or extensive debridement.
However, you will need to ensure that your surgeon is aware of the significance of these codes and documents all the procedures done in detail. Do not forget to confirm with your payer the protocols or definitions that the payer is using for the arthroscopic subacromial decompression when it is the only procedure performed.
The CPT® code +29826 changed from a standalone to an add-on code in 2012, meaning that you can now report this only when your surgeon does another scope procedure as the primary procedure.
Coders have been reporting code 29999 (Unlisted procedure, arthroscopy) when only an arthroscopic subacromial decompression of the shoulder was performed.
"Originally AAOS advised use of the unlisted procedure code 29999 when performing 29826 alone. Recent clarification from AMA/CPT is to use CPT® codes 29822 or 29823, depending upon the extent of debridement supported by the operative report," says Kristi Stumpf, MCS-P, CPC, COSC, ACS-OR, owner, Precision Auditing and Coding, senior orthopedic coder & auditor, The Coding Network, Washington.
"When performing an arthroscopic acromioplasty alone, submission using the unlisted arthroscopy code of 29999 has been widely practiced," says Ruby O'Brochta-Woodward, BSN, CPC, CCS-P, COSC, ACS-OR, compliance and research specialist, Twin Cities Orthopedics, P.A. "The AMA has long stood by the theory that if an appropriate code does not exist, the procedure should be submitted using the appropriate unlisted CPT® code."
This year's change means that you can now turn to 29822 (Arthroscopy, shoulder, surgical; debridement, limited) or 29823 (Arthroscopy, shoulder, surgical; debridement, extensive). "Both the AMA and AAOS have issued statements that the appropriate debridement code (29822 or 29823) should be reported when arthroscopic subacromial decompression is performed as a standalone procedure," says Heidi Stout, BA, CPC, COSC, PCS, CCS-P, Coder on Call, Inc., Milltown, New Jersey and orthopedic coding division director, The Coding Network, LLC, Beverly Hills, CA.
The scope procedures that you may commonly encounter for primary procedures are the arthroscopic claviculectomy, arthroscopic rotator cuff repair, arthroscopic debridement (debridement unrelated to the work performed for the decompression), or arthroscopic biceps tenodesis. "The add-on code +29826 is allowed with CPT® codes 29806 -- 29825, 29827 and 29828," says Stumpf. These are listed below:
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on "Add on code 29826 denial"
Was the 29826 59 denied correctly?
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on "Add on code 29826 denial"
Yes, Its an add on code for arthroscopic procedures, you cannot report it along with open procedures.
(Use 29826 in conjunction with 29806-29825, 29827, 29828)
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User id : 28709 on "Add on code 29826 denial"
Hi,
I need help on this one. I received a denial on 29826 59.
Procedures performed: 1. Left shoulder arthroscopy with subacromial decompression. 2. A
↧
↧
SuperCoder on "Add on code 29826 denial"
When your surgeon performs an arthroscopic subacromial decompression as the only procedure, you may turn to codes 29822 or 29823, depending upon wheth
↧
User id : 28709 on "Add on code 29826 denial"
Was the 29826 59 denied correctly?
↧
SuperCoder on "Add on code 29826 denial"
Yes, Its an add on code for arthroscopic procedures, you cannot report it along with open procedures.
(Use 29826 in conjunction with 29806-29825, 2982
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