How To Use CPT Code 29823

CPT 29823 refers to an extensive arthroscopic shoulder debridement procedure involving three or more discrete structures. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 29823.

1. What is CPT 29823?

CPT 29823 is a medical billing code used to describe an extensive arthroscopic shoulder debridement procedure that involves three or more discrete structures. This code is utilized by healthcare providers to accurately document and bill for the specific surgical services provided to patients with shoulder joint issues requiring extensive debridement.

2. 29823 CPT code description

The official description of CPT code 29823 is: “Arthroscopy, shoulder, surgical; debridement, extensive, 3 or more 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. The 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 an extensive debridement is performed, involving three or more discrete structures in the shoulder joint.
7. The area is irrigated, and bleeding is checked.
8. Instruments are removed, and incisions are closed.

4. Qualifying circumstances

Patients eligible to receive CPT code 29823 services are those with shoulder joint issues requiring extensive debridement involving three or more discrete structures. These issues may be due to trauma, degenerative conditions, or other causes that result in damaged tissues within the shoulder joint. The provider must determine that an arthroscopic approach is the most appropriate method for addressing the patient’s specific condition.

5. When to use CPT code 29823

It is appropriate to bill the 29823 CPT code when the provider performs an extensive arthroscopic shoulder debridement involving three or more discrete structures. This code should be used when the procedure is deemed medically necessary and is the most suitable approach for addressing the patient’s shoulder joint issues.

6. Documentation requirements

To support a claim for CPT 29823, the provider must document the following information in the patient’s medical record:

• Indication for the procedure, including the patient’s symptoms and diagnosis.
• Details of the procedure performed, including the specific structures involved in the debridement.
• Findings during the procedure, such as the extent of tissue damage and any additional issues identified.
• Postoperative care instructions and follow-up plan.

7. Billing guidelines

When billing for CPT code 29823, providers should adhere to the following guidelines:

• Ensure that the procedure is medically necessary and appropriately documented in the patient’s medical record.
• Use modifier 59 when reporting both a diagnostic arthroscopy and an open repair of a previously unknown condition.
• Be aware of any payer-specific rules or requirements related to billing for arthroscopic shoulder procedures.

8. Historical information

CPT 29823 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, extensive.”

9. Similar codes to CPT 29823

Five similar codes to CPT 29823 and how they differentiate are:

• CPT 29822: This code is used for limited debridement in the shoulder joint, involving fewer structures than CPT 29823.
• CPT 29824: This code describes an arthroscopic distal claviculectomy, which is a different procedure than extensive debridement.
• CPT 29825: This code is for arthroscopic removal of loose bodies or foreign bodies in the shoulder joint, not extensive debridement.
• CPT 29826: This code refers to an arthroscopic subacromial decompression, which is a different procedure than extensive debridement.
• CPT 29827: This code is used for arthroscopic rotator cuff repair, which is a different procedure than extensive debridement.

10. Examples

Here are 10 detailed examples of CPT code 29823 procedures:

1. A patient with a history of shoulder dislocations undergoes CPT 29823 for extensive debridement of the labrum, articular capsule, and biceps tendon.
2. A patient with severe osteoarthritis undergoes CPT 29823 for extensive debridement of the humeral bone, humeral articular cartilage, and glenoid bone.
3. A patient with a rotator cuff tear undergoes CPT 29823 for extensive debridement of the articular side of the rotator cuff, bursal side of the rotator cuff, and subacromial bursa.
4. A patient with a history of shoulder impingement undergoes CPT 29823 for extensive debridement of the subacromial bursa, biceps tendon, and biceps anchor complex.
5. A patient with a history of shoulder instability undergoes CPT 29823 for extensive debridement of the labrum, articular capsule, and glenoid articular cartilage.
6. A patient with a history of shoulder fractures undergoes CPT 29823 for extensive debridement of the humeral bone, glenoid bone, and foreign bodies.
7. A patient with a history of shoulder infections undergoes CPT 29823 for extensive debridement of the articular capsule, subacromial bursa, and foreign bodies.
8. A patient with a history of shoulder dislocations and rotator cuff tears undergoes CPT 29823 for extensive debridement of the labrum, articular side of the rotator cuff, and bursal side of the rotator cuff.
9. A patient with a history of shoulder impingement and osteoarthritis undergoes CPT 29823 for extensive debridement of the subacromial bursa, humeral bone, and humeral articular cartilage.
10. A patient with a history of shoulder instability and rotator cuff tears undergoes CPT 29823 for extensive debridement of the labrum, articular side of the rotator cuff, and biceps tendon.