A Look at Arthroscopic Shoulder Debridement CPT Codes 29822 & 29823
A Look at Arthroscopic Shoulder Debridement CPT Codes 29822 & 29823
What are the shoulder debridement surgery CPT codes?
- CPT code 29822 is for surgical shoulder arthroscopy with limited debridement of one or two discrete structures (AAPC).
- CPT code 29823 is for surgical shoulder arthroscopy with extensive debridement of three or more discrete structures (AAPC).
What are the other shoulder arthroscopy CPT codes?
- CPT code 29826 is for surgical shoulder arthroscopy with decompression of the subacromial space, partial acromioplasty, and release of the coracoacromial ligament (AAPC).
- CPT code 29827 is for surgical shoulder arthroscopy with rotator cuff repair (AAPC).
- CPT code 29828 is for surgical shoulder arthroscopy with biceps tenodesis procedure (AAPC).
What courses can I take on these Shoulder Debridement CPT Codes?
Updates to Shoulder Debridement CPT Codes
Are you up-to-date on the AMA CPT Code revisions from 2021 regarding codes 29822 and 29823 for arthroscopic shoulder debridement? The AMA revised the codes with some definitions of limited vs. extensive debridement. This comes after coders and providers struggled to determine the difference between limited or extensive debridement. Let’s look at the revised CPT codes:
CPT Code 29822 – Arthroscopy, shoulder, surgical; debridement, limited, one or two discrete structures (e.g., humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of the rotator cuff, subacromial bursa, foreign body[ies])
CPT Code 29823 – Arthroscopy, shoulder, surgical; debridement, extensive, three or more discrete structures (e.g., humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of the rotator cuff, subacromial bursa, foreign body[ies])
At first, the new descriptors seem easy to use. The difficulty depends on additional procedures done during the same surgery on the same shoulder. Per CPT Assistant December 2020 pg 8: “As with all other arthroscopic debridement codes, it is important to note that the structures debrided as part of another procedure reported for the same session cannot be counted to meet the criteria of the debridement code. For example, a bursal-sided supraspinatus tear cannot be counted as a debrided structure if the supraspinatus is repaired in the same session.”
AMA hopes that by specifying both the number and names of anatomical structures involved in shoulder debridement, coders and providers can more accurately select the appropriate code. This will be based on the medical documentation in the operative report. Coders should not be assigning the code based on the provider’s statement of extensive debridement.
Debridement and Structure Repairs
Coders must continue to review the detailed op note. This is to verify the structures debrided vs. the structures repaired/treated with another surgical CPT code. They also need to assign the debridement code based on the number of discrete structures debrided. Coders should not count structures towards debridement if providers perform another procedure on that same structure in the same operative session.
This change may cause coders to bump down some surgeries to code 29822 for the limited debridement. Officials remind coders to continue to follow NCCI edits for code 29822 if performed on the same shoulder. Per the NCCI edits (Chapter 4): “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. An NCCI PTP edit code pair consisting of two codes describing two shoulder arthroscopy procedures shall not be bypassed with an NCCI PTP-associated modifier when the two procedures are performed on the ipsilateral shoulder. This type of edit may be bypassed with an NCCI PTP-associated modifier only if the two procedures are performed on contralateral shoulders” (CMS, 2021).
Examples of the Revised Codes
Let’s look at some examples:
Example #1: Arthroscopic Rotator Cuff Repair, Biceps Tenodesis, Subacromial Decompression, Debridement of the Labrum and Biceps Tendon. Codes are: 29827, 29828, and 29826. Practitioners would not record any codes for the Labrum/Biceps debridement as it’s only one discrete site. Coders would bundle code 29822 per the NCCI edits. Coders would not count the biceps debridement towards the debridement. This is because the provider performed a repair of the same structure.
Example #2: Arthroscopic Rotator Cuff Repair, Distal Claviculectomy, Debridement of the Labrum, Glenoid Bone and Biceps Tendon. Codes are: 29827, 29824, and 29823. There are three separate and discrete structures debrided separately from the rotator cuff repair and distal claviculectomy.
Learn How to Code Shoulder Debridement Procedures
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The YES Auditing Team co-authored this article.
