How To Use CPT Code 29822

CPT 29822 refers to a limited arthroscopic shoulder debridement procedure, and this article will cover its description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples.

1. What is CPT 29822?

CPT 29822 is a medical billing code used to describe a limited arthroscopic shoulder debridement procedure. This code is utilized by medical coders and billers to accurately document and bill for the specific surgical service provided to a patient. The procedure involves the removal of damaged tissue from one or two discrete structures within the shoulder joint using an arthroscope and additional instruments.

2. 29822 CPT code description

The official description of CPT code 29822 is: “Arthroscopy, shoulder, surgical; debridement, limited, 1 or 2 discrete structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of the rotator cuff, subacromial bursa, foreign body[ies])”.

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider makes three small incisions in the shoulder area.
3. An arthroscope is inserted through one of the incisions into the shoulder joint.
4. Saline solution is instilled to expand the area around the shoulder joint.
5. The provider views the entire shoulder joint area using the camera of the scope.
6. Additional instruments are inserted, and a limited debridement is performed on one or two discrete structures within the shoulder joint.
7. The area is irrigated, and any bleeding is checked.
8. Instruments are removed, and the incisions are closed.

4. Qualifying circumstances

Patients eligible to receive CPT code 29822 services are those who have experienced shoulder trauma or have a medical condition that has resulted in damaged tissue within the shoulder joint. The damage must be limited to one or two discrete structures, such as the humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of the rotator cuff, subacromial bursa, or foreign bodies in the shoulder joint. The patient’s medical history, physical examination, and imaging studies should support the need for this procedure.

5. When to use CPT code 29822

It is appropriate to bill the 29822 CPT code when a limited arthroscopic shoulder debridement procedure is performed on a patient with damaged tissue in one or two discrete structures within the shoulder joint. The procedure should be medically necessary and supported by the patient’s medical history, physical examination, and imaging studies.

6. Documentation requirements

To support a claim for CPT 29822, the following information should be documented in the patient’s medical record:

• Patient’s medical history, including any relevant shoulder trauma or medical conditions.
• Physical examination findings related to the shoulder joint.
• Imaging studies, such as X-rays, MRI, or CT scans, that demonstrate the damaged tissue within the shoulder joint.
• Operative report detailing the limited arthroscopic shoulder debridement procedure, including the specific structures treated and the instruments used.
• Postoperative care plan and follow-up instructions.

7. Billing guidelines

When billing for CPT code 29822, it is essential to follow the specific guidelines and rules set forth by the American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS). Ensure that the procedure is medically necessary and supported by the patient’s medical history, physical examination, and imaging studies. Additionally, do not use a diagnostic code with a surgical code, as surgical endoscopy or arthroscopy always includes a diagnostic endoscopy or arthroscopy.

8. Historical information

CPT 29822 was added to the Current Procedural Terminology system on January 1, 1990. The code was changed on January 1, 2021, with the previous descriptor being “Arthroscopy, shoulder, surgical; debridement, limited.”

9. Similar codes to CPT 29822

Five similar codes to CPT 29822 and how they differentiate are:

1. CPT 29823: This code is used for extensive debridement, including the removal of damaged tissue from three or more discrete structures within the shoulder joint.
2. CPT 29824: This code describes an arthroscopic distal claviculectomy, which involves the removal of the distal end of the clavicle.
3. CPT 29825: This code is for an arthroscopic lysis of adhesions within the shoulder joint.
4. CPT 29826: This code refers to an arthroscopic subacromial decompression, which involves the removal of bone spurs or other structures causing impingement in the subacromial space.
5. CPT 29827: This code is for an arthroscopic rotator cuff repair, which involves the repair of a torn rotator cuff tendon.

10. Examples

Here are 10 detailed examples of CPT code 29822 procedures:

1. A patient with a history of shoulder dislocation undergoes a limited arthroscopic debridement of the labrum and articular capsule.
2. A patient with chronic shoulder pain and imaging showing damage to the humeral articular cartilage undergoes a limited arthroscopic debridement of the humeral articular cartilage and subacromial bursa.
3. A patient with a rotator cuff tear and associated bursal side damage undergoes a limited arthroscopic debridement of the bursal side of the rotator cuff and subacromial bursa.
4. A patient with a history of shoulder instability undergoes a limited arthroscopic debridement of the glenoid bone and glenoid articular cartilage.
5. A patient with a biceps tendon tear and associated damage to the biceps anchor complex undergoes a limited arthroscopic debridement of the biceps tendon and biceps anchor complex.
6. A patient with a history of shoulder impingement and damage to the articular side of the rotator cuff undergoes a limited arthroscopic debridement of the articular side of the rotator cuff and subacromial bursa.
7. A patient with a history of shoulder arthritis and damage to the humeral bone undergoes a limited arthroscopic debridement of the humeral bone and humeral articular cartilage.
8. A patient with a history of shoulder trauma and a foreign body in the shoulder joint undergoes a limited arthroscopic debridement and removal of the foreign body.
9. A patient with a history of shoulder instability and damage to the labrum and articular capsule undergoes a limited arthroscopic debridement of the labrum and articular capsule.
10. A patient with a history of shoulder impingement and damage to the bursal side of the rotator cuff undergoes a limited arthroscopic debridement of the bursal side of the rotator cuff and subacromial bursa.