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ASCs are leaving money on the table if they are not billing for limited arthroscopic shoulder debridement when warranted, according to Cristina Bentin, principal of Coding Compliance Management.
"There's a lot of underreporting of limited debridements of the shoulder," she says, which is reported with CPT code 29822 (Arthroscopy, shoulder, surgical; débridement, limited).
"Facilities need to realize that if there is a limited arthroscopic debridement being performed at the time of other arthroscopic procedures and if this debridement is not inclusive of those other procedures, then it can be reported separately — per the AMA and per Medicare edits — as long as it's separate and distinct from any of the other procedures performed during that surgical session," Ms. Bentin says
For example, while CPT 29822 normally bundles into CPT code 29824 (Arthroscopic, shoulder, surgical, distal claviculectomy), both may be reported if the limited debridement is performed on other areas of the shoulder unrelated to the area/work performed to complete the arthroscopic, distal claviculectomy. Medicare edits indicate potential reporting of normally inclusive codes (when separate/distinct) with a correct coding modifier (1), Ms. Bentin says.
Cristina Bentin can be reached at cristina@ccmpro.com. Learn more about Coding Compliance Management.
The information provided should be utilized for educational purposes only. Facilities are ultimately responsible for verifying the reporting policies of individual commercial and MAC/FI carriers prior to claim submissions.
ASCs are leaving money on the table if they are not billing for limited arthroscopic shoulder debridement when warranted, according to Cristina Bentin, principal of Coding Compliance Management.
"There's a lot of underreporting of limited debridements of the shoulder," she says, which is reported with CPT code 29822 (Arthroscopy, shoulder, surgical; débridement, limited).
"Facilities need to realize that if there is a limited arthroscopic debridement being performed at the time of other arthroscopic procedures and if this debridement is not inclusive of those other procedures, then it can be reported separately — per the AMA and per Medicare edits — as long as it's separate and distinct from any of the other procedures performed during that surgical session," Ms. Bentin says
For example, while CPT 29822 normally bundles into CPT code 29824 (Arthroscopic, shoulder, surgical, distal claviculectomy), both may be reported if the limited debridement is performed on other areas of the shoulder unrelated to the area/work performed to complete the arthroscopic, distal claviculectomy. Medicare edits indicate potential reporting of normally inclusive codes (when separate/distinct) with a correct coding modifier (1), Ms. Bentin says.
Cristina Bentin can be reached at cristina@ccmpro.com. Learn more about Coding Compliance Management.
The information provided should be utilized for educational purposes only. Facilities are ultimately responsible for verifying the reporting policies of individual commercial and MAC/FI carriers prior to claim submissions.