Shoulder Arthroscopy - is synovectomy included??
I’ve been noticing a lot of orthopedic surgeons sending bills for rotator cuff repair with a synovectomy.
Usually how they start is they perform synovectomy (sometimes with a partial SLAP repair) & then jump right into the start of rotator cuff repair.
As far as I understand if the synovectomy clears the way for the rotator cuff repair, it’s included with 29827.
I reviewed a bill (I work for insurance) and I went back and forth with myself a lot whether or not the synovectomy should be included. I ultimately didn’t allow it, but I think I may be wrong…
So in this particular instance, the surgeon cleared the synovitis in the glenohumeral joint, debrided the anterior labrum and then begin the rotator cuff repair at the subscapularis tendon. The surgeon then moved to subacromoal decompression & finished up the rotator cuff repair at the supraspinatus tendon. The surgeon very specifically stated that the muscle was detached from the humeral head. And performed a repair.
Anyway, today I waffled a lot on the first day. Figured I’d come back the second day & decided it was included. And now today I’m thinking I should have allowed the synovectomy.
I should probably stop worrying about it, because they will certainly send an appeal, so I will have an opportunity to correct my wrong, if in fact, I am wrong.
I’m new to my company, with no real experience with surgical coding before this & I asked my senior coder & she said “up to you” (they’re very big on our personal integrity & won’t ask us to put our name on something we don’t agree with, but I keep disagreeing with myself!)
Arg….what are your thoughts??