Skip to Main Content
Issue Number - Name
0057 - Arthroscopic Limited Shoulder Debridement
Review Type
Complex
Claim Type
Outpatient Hospital (OPH), Ambulatory Surgery Center (ASC), Physician/Non- Physician Practitioner (NPP)
Region and State
RAC 1-4
All States
Date Approved
2017-09-06

Description

Shoulder arthroscopy procedures include a limited debridement (e.g., CPT code 29822). Code 29822 is not separately payable when another shoulder arthroscopy procedure is billed and paid on the same shoulder for the same day for the same beneficiary at the same encounter.

Affected Code(s)

  • CPT codes 29822, 29805, 29806, 29807, 29819, 29820, 29821, 29823, 29824, 29825, 29827, 29828, 29805, 29806, 29807, 29819, 29820, 29821, 29823, 29824, 29825, 29827, 29828, 29822

Applicable Policy References

  • Title XVIII of the Social Security Act (SSA), Sections 1833(e) and 1862(a)(1)(A)
  • 42 Code of Federal Regulations, Sections 411.15(k)(1) and 424.5(a)(6)
  • CMS Pub. 100-02, Medicare Benefit Policy Manual, Chapter 16, Section 20
  • National Correct Coding Initiative Policy Manual, Chapter 4 E, “Arthroscopy”- Effective January 1, 2014- January 1, 2017