Coding Tips: Refresher on CPT Codes 29826 Use To Reflect Add-On Status in 2012

Refer to codes for arthroscopic debridement while reporting only arthroscopic subacromial decompression.

CPT® 2012 transforms the way you’ll report arthroscopic acromioplasties, so you’ll want to make certain you’re informed on applying code +29826 (Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament [i.e. arch] release, when performed [List separately in addition to code for primary procedure]), which is no longer an individual code. See the advice that follows for more on how to correctly report + 29826 plus CPT® codes for other primary procedures this year.

Document Additional Primary Procedures

The CPT® code +29826 transformed from a standalone to an add-on code in 2012, implying that you can now report this only when your surgeon carries out another scope procedure as the primary procedure.

Coders have been reporting code 29999 (Unlisted procedure, arthroscopy) while only an arthroscopic subacromial decompression of the shoulder was carried out.

Originally AAOS advised use of the unlisted procedure code 29999 while carrying out 29826 alone. Latest clarification from AMA/CPT is to use CPT® codes 29822 or 29823, depending upon the extent of debridement supported by the operative report.

While carrying out an arthroscopic acromioplasty alone, submission using the unlisted arthroscopy code of 29999 has been extensively practiced. The AMA has long stood by the theory that in case a correct code does not exist, the procedure must be submitted using the precise unlisted CPT® code.

This year’s change implies that you can now refer to 29822 (Arthroscopy, shoulder, surgical; debridement, limited) or 29823 (Arthroscopy, shoulder, surgical; debridement, extensive). Both the AMA and AAOS have issued statements that the suitable debridement code (29822 or 29823) must be reported while arthroscopic subacromial decompression is carried out as a standalone procedure.

The scope procedures that you may normally 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 permitted with CPT® codes 29806 -- 29825, 29827 and 29828. These are listed below:

• 29806 (Arthroscopy, shoulder, surgical; capsulorrhaphy)
• 29807 (Arthroscopy, shoulder, surgical; repair of SLAP lesion)
• 29819 (Arthroscopy, shoulder, surgical; with removal of loose body or foreign body)
• 29820 (Arthroscopy, shoulder, surgical; synovectomy, partial)
• 29821(Arthroscopy, shoulder, surgical; synovectomy, complete)
• 29822 (Arthroscopy, shoulder, surgical; debridement, limited)
• 29823 (Arthroscopy, shoulder, surgical; debridement, extensive)
• 29824 (Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface [Mumford procedure])
• 29825 (Arthroscopy, shoulder, surgical; with lysis and resection of adhesions, with or without manipulation)
• 29827 (Arthroscopy, shoulder, surgical; with rotator cuff repair)
• 29828 (Arthroscopy, shoulder, surgical; biceps tenodesis)