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Orif greater tuberosity fracture with repair of rotator cuff

H.E.L.P. !!!
Can I bill the rotator cuff repair with the ORIF of the greater tuberosity fracture? I checked the NCCI edits 23630 and 23410 have a 1 indicator. According to the NCCI edits I don’t think I should but maybe some of you have some advice.
Thanks so much!

Medical Billing and Coding Forum

Unlisted 29999 for arthroscopic corocplasty or micfrofracture of greater tuberosity

Hi there everyone,

I am struggling with an orthopedic office and an unlisted code of 29999, which I am using to code either an arthroscopic corocoplasty OR a micfrofracture of greater tuberosity. The surgeons office is not booking with this procedure and when we ask they say they are not going to do it, but end up doing it. The problem is with my Medicare patients, Medicare leaves it to their responsibilities, and I am not having them sign an ABN because the surgeon is stating he will not be doing that procedure. The surgeons office is not disclosing if they bill or not the 29999 (kind of shady). I need help with this code. Can the ortho clinic legally not bill this code even though it is on the op report? any advice would be helpful on this matter. I need something concrete to go to the surgeon ortho clinic about this, but I cannot find anything. Thank you

Medical Billing and Coding Forum

Greater tuberosity drilling procedure

Need some coding advice on this surgery

Dx: Partial Rotator Cuff Tear, Left Shoulder
Adhesive Capsulitis

Procedures Performed
Arthroscopy, Capsular Release
Decompression
Drilling Greater Tuberosity

These are the codes I have selected for the first 2 procedures
CPT 29825 for the capsular release
CPT 29826 for the decompression

I am unsure of the code to use for the Drilling of the Greater Tuberosity

I will quote from the portion of the operative note regarding this…."Four drill holes were made in the greater tuberosity. Four were just lateral to the insertion of the greater tuberosity and one was at the insertion where there was a small partial thickness tear. The drilling was done with the 0.0625 K-wire. Shoulder was drained. Portals were closed ……..

Not sure if this procedure should be included in the 29826

Thanks for any and all help,
CW

Medical Billing and Coding Forum