Can 29823 and 29828 be billed together?

Per the 2017 CMS NCCI Surgical Policy Manual code 29823 CAN be billed with 29824, 29827 & 29828 ONLY. Remember this is a CMS policy.

What is an allograft for shoulder surgery?

An allograft patch is sewn between the humerus and the shoulder socket (glenoid) preventing the humerus from sliding upwards – much like placing a trampoline above the humeral head to prevent it from sliding upwards with shoulder motion.

Can 29827 and 29828 be billed together?

You can bill 29827 & 29828 together as there is no edit that prohibits it. In 2017 CMS stated in the NCCI Surgical Policy Manual that the shoulder is considered “one anatomical” unit or location. As such, when billing Medicare or any insurance that follows their rules, you cannot bill any coding pair that hits an edit.

Can 29827 and 23430 be billed together?

For Medicare patients — and any other patients covered under federally-funded healthcare programs, such as Medicaid, federal BlueCross® BlueShield®, CHAMPVA, TRICARE®, and any other healthcare program provided to federal employees — code combinations 29806/29827 and 23472/23430 will be denied.

What is included in CPT 29828?

The Current Procedural Terminology (CPT®) code 29828 as maintained by American Medical Association, is a medical procedural code under the range – Endoscopy/Arthroscopy Procedures on the Musculoskeletal System.

What is allograft tendon?

An allograft is bone or soft tissue that is transplanted from one person to another.

How do allografts work?

Allograft tissue works through a process called “osteoconduction.” Imagine a vine growing through and around a trellis. Allograft tissue works in a similar fashion. Allograft is like a scaffold (trellis) that supports the bone-forming cells (the vine) as they grow new bone over time.

Can 29827 and 29807 be billed together?

It’s hard to bill a 29827, 29826 and 29807 all at the same time. The 29807 and 29822 are definitely bundled as you are doing work on the labrum for both and you can’t expect to get paid twice for the same area.

What is the difference between CPT 29806 and 29807?

If the repair is a SLAP, you’d code work done on the upper half of the labrum as 29807 (Arthroscopy, shoulder, surgical; repair of SLAP lesion). If the repair was in the lower half of the labrum, you’d use instead code 29806 (Arthroscopy, shoulder, surgical; capsulorraphy).

What is the CPT code 29823?

29823: Arthroscopy, shoulder, surgical; debridement, limited, 3 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.

What is the CPT code for rotator cuff surgery?

CPT® Code CPT Description 23410 Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; acute 23412 Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; chronic 23420 Reconstruction of complete shoulder (rotator) cuff avulsion, chronic (includes acromioplasty) 29827 Arthroscopy, shoulder, surgical; with rotator cuff repair

Is dermal allograft a viable option for rotator cuff repair?

supports the use of a decellularized dermal allograft as an option for augmentation in rotator cuff repair 2,3. This has led to significant clinical interest, particularly for challenging repairs such as revisions or when retears are a concern due to suboptimal tendon quality.

What is the CPT code for shoulder replacement?

not present CPT Code CPT Description OPPS Status Indicator APC ASC Payment Indicator 23410 Repair of ruptured musculotendinous cuff J1 5114 A2 23412 Repair of ruptured musculotendinous cuff J1 5114 A2 23420 Reconstruction of complete shoulder (rot J1 5114 A2

What is cuffmend rotator cuff augmentation?

Value Analysis Significance CuffMend rotator cuff repair augmentationprovides a straightforward approach for augmenting partial- and full-thickness rotator cuff tears using a decellularized dermal allograft to provide mechanical strength