Coding Arthroscopy Shoulder Procedures

CPT codes for shoulder arthroscopy requires good understanding of shoulder anatomy.

Arthroscopic coracoplasty (partial resection of the coracoid process’s posterolateral side) is not included in 29826. Report 29999.

CPT does not have a code for arthroscopic posterior remplissage, so report 29999 (Unlisted procedure, arthroscopy).

CPT code 29828 Arthroscopic biceps tenodesis does not include the arthroscopic bicep tenotomy. Report 29999 (Unlisted procedure, arthroscopy)

SLAP lesion is a superior labrum lesion not inferor labrum. Repair of a torn labrum should not be coded to 29807 because 29807 represents repair of SLAP tear and all labral tears are not SLAP tears. According to AAOS report 29806 with 29807 only if the SLAP lesion repair is Type 2 or Type 4. For the other 5 types of SLAP lesions, it may not be appropriate to report 29807 with 29806.

Repair (debridement) of a type I SLAP lesion is always coded as 29822 (Arthroscopic debridement, limited). Repairs of types II and IV SLAP lesions are coded 29807 (Repair SLAP lesion) because an actual repair is performed.

Type III SLAP lesions are bucket-handle tears and can be either debrided or repaired; use 29822 or 29807, whichever is appropriate. Adding code 29806 (Arthroscopy, shoulder, surgical, capsulorrhaphy) for repair of a SLAP lesion is never appropriate unless there is a capsular defect in an area different than the SLAP. This is one of the most common coding errors. Even if a staple or other device goes through the capsule to repair the SLAP, capsulorrhaphy should not be coded separately.

A partial synovectomy (29820) or limited debridement (29822) would consist of work done in just a portion of the shoulder, such as the front or the back of the shoulder. To support a complete synovectomy (29821) or extensive debridement (29823), the documentation should support work in BOTH the front and back of the shoulder.

CPT code for arthroscopic distal clavicle resection includes extensive debridement.

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