CPT 29827 is a surgical code for arthroscopic shoulder repair, specifically focusing on rotator cuff repair. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 29827 procedures.
1. What is CPT 29827?
CPT 29827 is a surgical code used to describe an arthroscopic procedure performed on the shoulder joint, specifically focusing on the repair of a torn rotator cuff. The rotator cuff is a group of muscles and tendons that surround and support the shoulder joint, and its repair is essential for restoring function and alleviating pain caused by injuries or repetitive overhead motion of the arm.
2. 29827 CPT code description
The official description of CPT code 29827 is: “Arthroscopy, shoulder, surgical; with rotator cuff repair.”
- 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 inflate the area around the shoulder joint and improve the field of view.
- The provider inspects the tendons and muscles of the rotator cuff area.
- Additional instruments are inserted to repair tears to the soft tissues, remove bone spurs, and free up adhesions.
- The area is irrigated, checked for bleeding, and any instruments are removed.
- The incision is closed.
4. Qualifying circumstances
Patients eligible to receive CPT 29827 services are those who have a torn rotator cuff due to sports injuries, repetitive overhead motion of the arm, or other causes that result in pain and limitation of movement. The provider must determine that an arthroscopic repair is the most appropriate treatment option for the patient, considering factors such as the severity of the tear, the patient’s overall health, and the potential risks and benefits of the procedure.
5. When to use CPT code 29827
It is appropriate to bill the 29827 CPT code when the provider performs an arthroscopic shoulder surgery specifically for the repair of a torn rotator cuff. The code should not be used for diagnostic arthroscopy or open repair procedures. Additionally, if the provider performs a diagnostic arthroscopy first and discovers the need for an open repair of a previously unknown condition, both the open repair and the diagnostic arthroscopy can be reported by appending modifier 59 to the diagnostic arthroscopy.
6. Documentation requirements
To support a claim for CPT 29827, the provider must document the following information:
- Patient’s medical history and physical examination findings, including the presence of a rotator cuff tear and related symptoms.
- Diagnostic imaging results, such as MRI or ultrasound, confirming the presence of a rotator cuff tear.
- Indication for the arthroscopic repair, including the rationale for choosing this procedure over other treatment options.
- Detailed description of the surgical procedure, including the steps taken to repair the rotator cuff.
- Postoperative care instructions and follow-up plan.
7. Billing guidelines
When billing for CPT code 29827, it is important to follow the appropriate guidelines and rules to ensure accurate reimbursement. Some tips and codes that apply to CPT 29827 include:
- Do not use a diagnostic code with a surgical code, as surgical endoscopy and arthroscopy always include a diagnostic endoscopy or arthroscopy.
- For open or mini-open rotator cuff repair, use CPT 23412 instead of CPT 29827.
- When arthroscopic distal clavicle resection is performed at the same setting, use CPT 29824 and append modifier 51.
8. Historical information
CPT 29827 was added to the Current Procedural Terminology system on January 1, 2003. There have been no updates to the code since its addition.
9. Similar codes to CPT 29827
Five similar codes to CPT 29827 and how they differentiate from CPT 29827 are:
- CPT 29806: This code is for arthroscopic shoulder capsulorrhaphy, which focuses on the repair of the shoulder joint capsule rather than the rotator cuff.
- CPT 29819: This code is for arthroscopic shoulder debridement, which involves the removal of damaged tissue from the shoulder joint but does not include rotator cuff repair.
- CPT 29822: This code is for arthroscopic shoulder debridement with limited soft tissue removal, which is a less extensive procedure than CPT 29827.
- CPT 29823: This code is for arthroscopic shoulder debridement with extensive soft tissue removal, which is a more extensive procedure than CPT 29827 but does not include rotator cuff repair.
- CPT 23412: This code is for open or mini-open rotator cuff repair, which is a different approach to repairing the rotator cuff compared to the arthroscopic method described by CPT 29827.
Here are 10 detailed examples of CPT code 29827 procedures:
- A 45-year-old patient with a rotator cuff tear due to a sports injury undergoes arthroscopic repair.
- A 60-year-old patient with a rotator cuff tear caused by repetitive overhead motion of the arm undergoes arthroscopic repair.
- A patient with a partial rotator cuff tear and significant pain undergoes arthroscopic repair to alleviate symptoms and restore function.
- A patient with a rotator cuff tear and associated bone spurs undergoes arthroscopic repair and removal of the bone spurs.
- A patient with a rotator cuff tear and adhesive capsulitis undergoes arthroscopic repair and release of adhesions.
- A patient with a rotator cuff tear and associated labral tear undergoes arthroscopic repair of both structures.
- A patient with a rotator cuff tear and associated biceps tendonitis undergoes arthroscopic repair and biceps tenodesis.
- A patient with a rotator cuff tear and associated subacromial impingement undergoes arthroscopic repair and subacromial decompression.
- A patient with a rotator cuff tear and associated instability undergoes arthroscopic repair and stabilization of the shoulder joint.
- A patient with a rotator cuff tear and associated arthritis undergoes arthroscopic repair and debridement of the arthritic joint surfaces.