CPT 29827 (Arthroscopy, shoulder, surgical; with rotator cuff repair) is a highly scrutinized orthopedic code due to massive bundling regulations within the shoulder joint.
What is Bundled into 29827?
When you bill a surgical arthroscopy (29827), Medicare inherently bundles the diagnostic arthroscopy (29870). You cannot bill a diagnostic scope just because the surgeon "took a look around" before doing the repair.
Additionally, limited debridement (29822) is always bundled into the repair. If the surgeon performs extensive debridement (29823), it can be billed separately only if it is performed in a completely different area of the shoulder.
Medical Necessity
Common ICD-10 codes include M75.12- (Complete tear of rotator cuff). Ensure you are specifying traumatic vs non-traumatic tears.
NCCI Edits and Modifiers
If billing 29827 and 29823 (Extensive debridement) together, you must append Modifier 59 to 29823, and the operative note must explicitly document the separate areas debrided.