This email will focus on changes to CPT Codes 29822/29823 debridements relative to the shoulder. It will help you determine when the removals are separate and distinct from other procedures performed in the same operative session as well as the difference between limited vs. extensive debridements as it relates to 29822/29823.
In case you haven’t already incorporated this information into your billing, here are the relevant items:
Shoulder Debridement
The AMA is providing guidance as to the difference between 29822 (limited debridement) and 29823 (extensive debridement) for documentation and billing purposes. They have changed the whole description of these two codes.
The codes for 2021 will now read:
29822 – Arthroscopy, surgical; debridement, limited, 1 or 2 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))
29823 – Arthroscopy, surgical; debridement, extended, 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, subacromial bursa, foreign body(ies))
This is an either/or choice. For example, if you debride 5 structures, you would choose 29823. You can’t use one code for 2 structures and another for the other 3.
Important note: Keep in mind that if you debride the structure prior to doing a repair, that debridement is considered inclusive in the repair. For example, when debriding the articular and bursal side of the rotator cuff and then going on to repair the cuff, only 29827 would be reported.
Here is the difference between LIMITED and EXTENSIVE debridement:
- If the surgeon debrides 1 to 2 “discrete structures” in the shoulder, it’s limited (29822).
- If the surgeon debrides 3 or more, it would be coded as extensive (29823).
- Bone and soft tissues qualify as discrete structures.
For the latest clarification on Arthroscopic Loose Body Removals, please click here
