CPT 29807 refers to the arthroscopic surgical repair of a SLAP lesion in the shoulder joint. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 29807.
1. What is CPT 29807?
CPT 29807 is a medical billing code used to describe the arthroscopic surgical repair of a SLAP (Superior Labrum Anterior and Posterior) lesion in the shoulder joint. This procedure is typically performed to treat shoulder instability, pain, or dysfunction caused by a tear in the labrum, which is the cartilage that surrounds the shoulder socket.
2. 29807 CPT code description
The official description of CPT code 29807 is: “Arthroscopy, shoulder, surgical; repair of SLAP lesion.”
- The patient is appropriately prepped and anesthetized.
- The provider makes an incision in the shoulder area.
- The arthroscope is inserted through the incision and into the shoulder joint.
- Saline solution is instilled to expand the area around the joint, improving the field of view.
- The provider inspects the labrum, biceps tendon, and head of the humerus.
- Instruments are inserted to excise the torn part of the labrum and stitch the area if necessary.
- The area is irrigated, checked for bleeding, and instruments are removed.
- The incision is closed.
4. Qualifying circumstances
Patients eligible to receive CPT 29807 services are those who have been diagnosed with a SLAP lesion in the shoulder joint, typically resulting from sports activities, shoulder trauma, or degenerative changes. The patient should have symptoms such as shoulder instability, pain, or dysfunction that have not improved with conservative treatments like physical therapy, medication, or rest.
5. When to use CPT code 29807
It is appropriate to bill the 29807 CPT code when a provider performs an arthroscopic surgical repair of a SLAP lesion in the shoulder joint. This code should be used only for the surgical repair of the lesion and not for diagnostic arthroscopy or other unrelated procedures performed during the same session.
6. Documentation requirements
To support a claim for CPT 29807, the following information should be documented in the patient’s medical record:
- Diagnosis of a SLAP lesion in the shoulder joint
- Conservative treatments attempted and their outcomes
- Indications for the surgical repair, such as persistent symptoms or functional limitations
- Details of the surgical procedure, including the steps performed and any complications encountered
- Postoperative care instructions and follow-up plan
7. Billing guidelines
When billing for CPT code 29807, keep in mind the following guidelines and rules:
- Report only one unit of 29807, even if sutures are placed both anterosuperiorly and posterosuperiorly for SLAP lesions.
- Surgical endoscopy and arthroscopy always include a diagnostic endoscopy or arthroscopy, so do not use a diagnostic code with a surgical code.
- If a diagnostic arthroscopy is performed and an open repair of a previously unknown condition is discovered, report both the open repair code and the diagnostic arthroscopy code by appending the 59 modifier, Distinct procedural service, to the diagnostic arthroscopy.
8. Historical information
CPT 29807 was added to the Current Procedural Terminology system on January 1, 2002. The code was changed on January 1, 2004, with the previous descriptor being “Arthroscopy, shoulder, surgical; repair of slap lesion.”
9. Similar codes to CPT 29807
Five similar codes to CPT 29807 and how they differentiate are:
- CPT 29806: This code is for arthroscopic repair of a Bankart lesion, which involves the anterior-inferior labrum of the shoulder joint.
- CPT 29819: This code is for arthroscopic debridement of the shoulder joint, which involves the removal of damaged tissue without repairing the labrum.
- CPT 29822: This code is for arthroscopic limited debridement of the shoulder joint, which is a less extensive debridement procedure.
- CPT 29823: This code is for arthroscopic extensive debridement of the shoulder joint, which is a more extensive debridement procedure.
- CPT 29824: This code is for arthroscopic distal claviculectomy, which involves the removal of the distal end of the clavicle in the shoulder joint.
Here are 10 detailed examples of CPT code 29807 procedures:
- A patient with a history of shoulder dislocations undergoes arthroscopic repair of a SLAP lesion to stabilize the shoulder joint.
- A baseball pitcher with persistent shoulder pain and instability undergoes arthroscopic SLAP lesion repair to restore function and alleviate symptoms.
- A patient with a traumatic shoulder injury undergoes arthroscopic repair of a SLAP lesion to address the resulting shoulder instability.
- An individual with a degenerative SLAP lesion undergoes arthroscopic repair to improve shoulder function and reduce pain.
- A patient with a history of failed conservative treatments for a SLAP lesion undergoes arthroscopic repair to address ongoing symptoms.
- A patient with a SLAP lesion and associated biceps tendon pathology undergoes arthroscopic repair of the lesion and biceps tenodesis.
- An athlete with a SLAP lesion and associated rotator cuff tear undergoes arthroscopic repair of both the SLAP lesion and the rotator cuff tear.
- A patient with a complex SLAP lesion undergoes arthroscopic repair with multiple suture anchors to stabilize the shoulder joint.
- A patient with a SLAP lesion and associated glenohumeral joint arthritis undergoes arthroscopic repair of the lesion and microfracture of the glenoid.
- A patient with a SLAP lesion and associated subacromial impingement undergoes arthroscopic repair of the lesion and subacromial decompression.