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29824 denied for bundling with 29827

I’m at my wits end. A Blue Cross Medicare Advantage plan is denying CPT 29824 as being bundled with 29827. Both procedures were most definitely done. I tried billing with a modifier 51 and it’s still denied as bundled. Chart notes have been submitted. They insist that this code is bundled into the rotator cuff repair and not separately billable.

Any suggestions? Medicare links? Anything?

Any help would be appreciated.

Medical Billing and Coding Forum

Shoulder arthroscopy codes 29824 and 29826

HI I am second guessing myself and would like some opinions please.
Does the following documentation support a 29824 (for the distal clavicle resection) and a 29826 (decompression of subacromial space)

"I then turned my attention subacromially. I did a subtotal bursectomy using a shaver and ArthroCare. I then burred down the anterior type 2-3 hooked acromion
using a 5.5 barrell burr, as well as the lateral acromion. I localized the AC joint. This was stenotic and arthritic. I removed the distal centimeter of clavicle and re-created the AC joint space. My decompression was complete. All instrumentation was removed. My portals were closed with steri-strips. A sterile dressing was applied. "

Thank you!
Kristy

Medical Billing and Coding Forum

29823 with codes 29827, 29828, and 29824

Please if someone can clarify for me, it has been approved for the code 29823 to be used with the codes 29827, 29824, and 29828 as of 7/1/16. Is this if the extensive debridement was on something other than the rotator cuff, bicep tendon or the distal clavicle if working or repairing in the same session? For example my doctor wrote "Extensive debridement of the undersurface of the cuff tear was performed. The biceps was then released proximal to the sutures and the stump and labral tear was debrided back extensively". Can someone please clarify for me?:confused:

Medical Billing and Coding Forum