Easy Tips for CPT code 29806 Capsulorrhaphy

Procedure performed for CPT code 29806 Capsulorrhaphy

There is much confusion for coding orthopedic procedures and CPT Code 29806 is one of them. In addition, we have similar CPT Code 29807, which is also tricky when have to be used with CPT Code 29806. So, first we will just checkout how the whole procedure is performed.  The patient is positioned side lying with his arm suspended. Anesthesia is administered. Two to four small holes incisions are made around the shoulder joint to allow access to all the areas of shoulder joint.

A solution in injection through one of the holes to clean the joint for proper visualization. The arthroscope is then inserted to perform an arthroscopic diagnostic exam in the shoulder joint. The anterior capsule is visualized from a transverse incision of the subscapularis tendon. The joint is explored to check for any damage after the quality and laxity of capsule is assessed. The joint is irrigated to remove any loose bodies. If there is no abnormal laxity, the capsule is attached to the labrum with sutures.

Once the capsule is reattached, the subscapularis tendon is reapproximated but not tightened and repaired. The joint is irrigated and suture or steri-strip closes the incisions. Orthopedic procedures are very important for Medical coding Certification exam. Learning tips and techniques can help in Clearing CPC exam in future.

29806– Arthroscopy, shoulder, surgical; capsulorrhaphy

29807 repair of SLAP lesion

SLAP lesions are injuries to the labrum that extend from anterior to the biceps tendon to posterior to the biceps tendon. For a SLAP lesion repair, the physician makes small percutaneous incisions for the arthroscope, the suture hook, and the cannula. The surgeon prepares the bony bed with a small ball burr and drills or punches a hole at the cartilage bone junction of the superior labrum.

A hook is passed through the anterior superior portal and the inside limb is grasped with a suture retrieval forceps. The physician sets an anchor into the drill hole by mounting the suture anchor on the inserter and sliding it down the suture. The physician closes the loop with a slipknot that is tied and tightened outside the cannula. A knot pusher secures the knot under arthroscopic control. A long-acting local anesthetic may be injected into the joint to help with postoperative pain. The joint is irrigated and suture, band aid, or Steri-strips close the incisions. The area is covered with a dressing and a sling or shoulder immobilizer is applied.

Read also: Tips for Carpal Tunnel Syndrome Coding

shoulder cap

Point to remember with CPT Code 29806

Use 50 modifier with CPT Code 29806 when the Capsulorrhaphy is performed on both sides bilaterally.

Surgical Arthroscopy always includes diagnostic arthroscopy.

Do use 51 modifier when the arthroscopy is performed with arthrotomy.

For open Thermal Capsulorrhaphy, use unlisted procedure CPT Code 23929.

For arthroscopic thermal capsulorrhapy, use unlisted procedure code 29999.

Read also: Coding tips for Knee Arthroscopic Procedures

Medically Unlikely Edits

An MUE for a HCPCS/CPT code is the maximum units of service (UOS) that a provider would report under most circumstances for a single beneficiary on a single date of service. Not all HCPCS/CPT codes have an MUE.

(MUE Adjudication Indicator (MAI))

The MUE for CPT code 29806 is 1
The MAI is 2 Date of Service Edit: Policy
MUE Rationale: CMS Policy

NCCI edits for CPT code 29806

Major Code/Column 1Minor Code/Column 2Effective DateDeletion DateModifier/Policy Indicator
2980619957/1/200212/31/20060-Not allowed
298060213T7/1/2010*0-Not allowed
298060216T7/1/2010*0-Not allowed
298060228T10/1/201012/31/20200-Not allowed
298060230T10/1/201012/31/20200-Not allowed
298060566T1/1/2020*1-Allowed
298060596T1/1/2021*1-Allowed
298060597T1/1/2021*1-Allowed
298060708T1/1/2022*1-Allowed
298060709T1/1/2022*1-Allowed
298061200110/1/2012*1-Allowed
298061200210/1/2012*1-Allowed
298061200410/1/2012*1-Allowed
298061200510/1/2012*1-Allowed
298061200610/1/2012*1-Allowed
298061200710/1/2012*1-Allowed
298061201110/1/2012*1-Allowed
298061201310/1/2012*1-Allowed
298061201410/1/2012*1-Allowed
298061201510/1/2012*1-Allowed
298061201610/1/2012*1-Allowed
298061201710/1/2012*1-Allowed
298061201810/1/2012*1-Allowed
298061202010/1/2012*1-Allowed
298061202110/1/2012*1-Allowed
298061203110/1/2012*1-Allowed
298061203210/1/2012*1-Allowed
298061203410/1/2012*1-Allowed
298061203510/1/2012*1-Allowed
298061203610/1/2012*1-Allowed
298061203710/1/2012*1-Allowed
298061204110/1/2012*1-Allowed
298061204210/1/2012*1-Allowed
298061204410/1/2012*1-Allowed
298061204510/1/2012*1-Allowed
298061204610/1/2012*1-Allowed
298061204710/1/2012*1-Allowed
298061205110/1/2012*1-Allowed
298061205210/1/2012*1-Allowed
298061205310/1/2012*1-Allowed
298061205410/1/2012*1-Allowed
298061205510/1/2012*1-Allowed
298061205610/1/2012*1-Allowed
298061205710/1/2012*1-Allowed
298061310010/1/2012*1-Allowed
298061310110/1/2012*1-Allowed
298061310210/1/2012*1-Allowed
298061312010/1/2012*1-Allowed
298061312110/1/2012*1-Allowed
298061312210/1/2012*1-Allowed
298061313110/1/2012*1-Allowed
298061313210/1/2012*1-Allowed
298061313310/1/2012*1-Allowed
298061315010/1/201212/31/20131-Allowed
298061315110/1/2012*1-Allowed
298061315210/1/2012*1-Allowed
298061315310/1/2012*1-Allowed
29806206001/1/20119/30/20221-Allowed
29806206041/1/2015*1-Allowed
29806206051/1/2011*1-Allowed
29806206061/1/2015*1-Allowed
29806206101/1/2011*1-Allowed
29806206111/1/2015*1-Allowed
29806207041/1/2020*1-Allowed
29806236504/1/2011*1-Allowed
29806236554/1/2011*1-Allowed
29806236604/1/2011*1-Allowed
29806236654/1/2011*1-Allowed
29806236704/1/2011*1-Allowed
29806236754/1/2011*1-Allowed
29806236804/1/2011*1-Allowed
29806237007/1/2002*1-Allowed
29806298057/1/2002*1-Allowed
29806298077/1/2004*1-Allowed
29806298197/1/2004*1-Allowed
29806298207/1/2004*1-Allowed
29806298217/1/2004*1-Allowed
29806298227/1/2002*1-Allowed
29806298237/1/2004*1-Allowed
29806298257/1/2004*1-Allowed
29806298267/1/200412/31/20111-Allowed
298063600010/1/2002*1-Allowed
29806364004/1/2009*1-Allowed
29806364054/1/2009*1-Allowed
29806364064/1/2009*1-Allowed
298063641010/1/2002*1-Allowed
29806364204/1/2009*1-Allowed
29806364254/1/2009*1-Allowed
29806364304/1/2009*1-Allowed
29806364404/1/2009*1-Allowed
298063659110/1/2015*0-Not allowed
298063659210/1/2015*0-Not allowed
29806366004/1/2009*1-Allowed
29806366404/1/2009*1-Allowed
298063720210/1/200212/31/20151-Allowed
29806437524/1/2009*1-Allowed
298065170110/1/2007*1-Allowed
298065170210/1/2007*1-Allowed
298065170310/1/2007*1-Allowed
29806616501/1/20161/1/20169-Not applicable
29806623104/1/200912/31/20160-Not allowed
29806623114/1/200912/31/20160-Not allowed
298066231810/1/200212/31/20160-Not allowed
298066231910/1/200212/31/20160-Not allowed
29806623201/1/2017*0-Not allowed
29806623211/1/2017*0-Not allowed
29806623221/1/2017*0-Not allowed
29806623231/1/2017*0-Not allowed
29806623241/1/2017*0-Not allowed
29806623251/1/2017*0-Not allowed
29806623261/1/2017*0-Not allowed
29806623271/1/2017*0-Not allowed
29806644004/1/2009*0-Not allowed
29806644024/1/200912/31/20190-Not allowed
29806644054/1/2009*0-Not allowed
29806644084/1/2009*0-Not allowed
29806644104/1/200912/31/20190-Not allowed
29806644124/1/200912/31/20150-Not allowed
29806644134/1/200912/31/20190-Not allowed
298066441510/1/2002*0-Not allowed
29806644161/1/2003*0-Not allowed
298066441710/1/2002*0-Not allowed
29806644184/1/2009*0-Not allowed
29806644204/1/2009*0-Not allowed
29806644214/1/2009*0-Not allowed
29806644254/1/2009*0-Not allowed
29806644304/1/2009*0-Not allowed
29806644354/1/2009*0-Not allowed
29806644454/1/2009*0-Not allowed
29806644464/1/2009*0-Not allowed
29806644474/1/2009*0-Not allowed
29806644484/1/2009*0-Not allowed
29806644494/1/2009*0-Not allowed
298066445010/1/2002*1-Allowed
29806644511/1/2020*0-Not allowed
29806644541/1/2020*1-Allowed
29806644611/1/2016*0-Not allowed
29806644624/1/2017*0-Not allowed
29806644631/1/2016*0-Not allowed
298066447010/1/200212/31/20090-Not allowed
298066447510/1/200212/31/20090-Not allowed
29806644794/1/2009*0-Not allowed
29806644804/1/2017*0-Not allowed
29806644834/1/2009*0-Not allowed
29806644844/1/2017*0-Not allowed
29806644861/1/2015*0-Not allowed
29806644871/1/2015*0-Not allowed
29806644881/1/2015*0-Not allowed
29806644891/1/2015*0-Not allowed
29806644901/1/2010*0-Not allowed
29806644914/1/2017*0-Not allowed
29806644924/1/2017*0-Not allowed
29806644931/1/2010*0-Not allowed
29806644944/1/2017*0-Not allowed
29806644954/1/2017*0-Not allowed
29806645054/1/2009*0-Not allowed
29806645084/1/200912/31/20180-Not allowed
29806645104/1/2009*0-Not allowed
29806645174/1/2009*0-Not allowed
29806645204/1/2009*0-Not allowed
29806645304/1/2009*0-Not allowed
29806645504/1/20094/1/20099-Not applicable
298066999010/1/2002*0-Not allowed
298067600010/1/2009*1-Allowed
298067600110/1/200912/31/20181-Allowed
29806770011/1/2011*1-Allowed
29806770021/1/2011*1-Allowed
29806907601/1/200612/31/20081-Allowed
29806907651/1/200612/31/20081-Allowed
29806907721/1/200612/31/20081-Allowed
29806907741/1/200612/31/20081-Allowed
29806907751/1/200612/31/20081-Allowed
298069078010/1/200212/31/20041-Allowed
29806920127/1/20137/1/20139-Not applicable
29806920124/1/2014*1-Allowed
29806920144/1/2014*1-Allowed
29806920147/1/20137/1/20139-Not applicable
29806930004/1/2009*1-Allowed
29806930054/1/2009*1-Allowed
29806930104/1/2009*1-Allowed
29806930404/1/2009*1-Allowed
29806930414/1/2009*1-Allowed
29806930424/1/2009*1-Allowed
29806933184/1/2009*1-Allowed
29806933551/1/2015*1-Allowed
29806940024/1/2009*1-Allowed
29806942004/1/2009*1-Allowed
29806942504/1/200912/31/20201-Allowed
29806946804/1/2009*1-Allowed
29806946814/1/2009*1-Allowed
29806946904/1/2009*1-Allowed
29806947704/1/200912/31/20201-Allowed
29806958124/1/2009*1-Allowed
29806958134/1/2009*1-Allowed
29806958164/1/2009*1-Allowed
29806958194/1/2009*1-Allowed
29806958224/1/2009*1-Allowed
29806958294/1/2009*1-Allowed
29806959554/1/2009*1-Allowed
29806963601/1/2009*1-Allowed
29806963614/1/2016*1-Allowed
29806963651/1/2009*1-Allowed
29806963664/1/2016*1-Allowed
29806963674/1/2016*1-Allowed
29806963684/1/2016*1-Allowed
29806963721/1/2009*1-Allowed
29806963741/1/2009*1-Allowed
29806963751/1/2009*1-Allowed
29806963764/1/2009*1-Allowed
29806963771/1/2017*1-Allowed
29806965234/1/2019*0-Not allowed
298069914810/1/200912/31/20160-Not allowed
298069914910/1/200912/31/20160-Not allowed
298069915010/1/200912/31/20160-Not allowed
29806991551/1/2017*0-Not allowed
29806991561/1/2017*0-Not allowed
29806991571/1/2017*0-Not allowed
298069921110/1/2020*1-Allowed
29806992117/1/201312/31/20191-Allowed
298069921210/1/2020*1-Allowed
29806992127/1/201312/31/20191-Allowed
298069921310/1/2020*1-Allowed
29806992137/1/201312/31/20191-Allowed
298069921410/1/2020*1-Allowed
29806992147/1/201312/31/20191-Allowed
29806992157/1/201312/31/20191-Allowed
298069921510/1/2020*1-Allowed
29806992177/1/201312/31/20191-Allowed
298069921710/1/202012/31/20221-Allowed
29806992187/1/201312/31/20191-Allowed
298069921810/1/202012/31/20221-Allowed
29806992197/1/201312/31/20191-Allowed
298069921910/1/202012/31/20221-Allowed
298069922010/1/202012/31/20221-Allowed
29806992207/1/201312/31/20191-Allowed
29806992217/1/201312/31/20191-Allowed
298069922110/1/2020*1-Allowed
29806992227/1/201312/31/20191-Allowed
298069922210/1/2020*1-Allowed
29806992237/1/201312/31/20191-Allowed
298069922310/1/2020*1-Allowed
29806992317/1/201312/31/20191-Allowed
298069923110/1/2020*1-Allowed
29806992327/1/201312/31/20191-Allowed
298069923210/1/2020*1-Allowed
29806992337/1/201312/31/20191-Allowed
298069923310/1/2020*1-Allowed
29806992347/1/201312/31/20191-Allowed
298069923410/1/2020*1-Allowed
29806992357/1/201312/31/20191-Allowed
298069923510/1/2020*1-Allowed
29806992367/1/201312/31/20191-Allowed
298069923610/1/2020*1-Allowed
29806992387/1/201312/31/20191-Allowed
298069923810/1/2020*1-Allowed
29806992397/1/201312/31/20191-Allowed
298069923910/1/2020*1-Allowed
29806992417/1/201312/31/20221-Allowed
29806992427/1/2013*1-Allowed
29806992437/1/2013*1-Allowed
29806992447/1/2013*1-Allowed
29806992457/1/2013*1-Allowed
29806992517/1/201312/31/20221-Allowed
29806992527/1/2013*1-Allowed
29806992537/1/2013*1-Allowed
29806992547/1/2013*1-Allowed
29806992557/1/2013*1-Allowed
29806992917/1/201312/31/20191-Allowed
298069929110/1/2020*1-Allowed
29806992927/1/201312/31/20191-Allowed
298069929210/1/2020*1-Allowed
29806993047/1/201312/31/20191-Allowed
298069930410/1/2020*1-Allowed
29806993057/1/201312/31/20191-Allowed
298069930510/1/2020*1-Allowed
29806993067/1/201312/31/20191-Allowed
298069930610/1/2020*1-Allowed
29806993077/1/201312/31/20191-Allowed
298069930710/1/2020*1-Allowed
29806993087/1/201312/31/20191-Allowed
298069930810/1/2020*1-Allowed
29806993097/1/201312/31/20191-Allowed
298069930910/1/2020*1-Allowed
29806993107/1/201312/31/20191-Allowed
298069931010/1/2020*1-Allowed
29806993157/1/201312/31/20191-Allowed
298069931510/1/2020*1-Allowed
29806993167/1/201312/31/20191-Allowed
298069931610/1/2020*1-Allowed
29806993347/1/201312/31/20191-Allowed
298069933410/1/202012/31/20221-Allowed
29806993357/1/201312/31/20191-Allowed
298069933510/1/202012/31/20221-Allowed
29806993367/1/201312/31/20191-Allowed
298069933610/1/202012/31/20221-Allowed
298069933710/1/202012/31/20221-Allowed
29806993377/1/201312/31/20191-Allowed
298069934710/1/2020*1-Allowed
29806993477/1/201312/31/20191-Allowed
298069934810/1/2020*1-Allowed
29806993487/1/201312/31/20191-Allowed
298069934910/1/2020*1-Allowed
29806993497/1/201312/31/20191-Allowed
298069935010/1/2020*1-Allowed
29806993507/1/201312/31/20191-Allowed
29806993747/1/2013*1-Allowed
29806993757/1/2013*1-Allowed
29806993777/1/2013*1-Allowed
29806993787/1/2013*1-Allowed
29806994461/1/2014*0-Not allowed
29806994471/1/2014*0-Not allowed
29806994481/1/2014*0-Not allowed
29806994491/1/2014*0-Not allowed
29806994511/1/2019*0-Not allowed
29806994521/1/2019*0-Not allowed
298069949510/1/2020*0-Not allowed
29806994951/1/201412/31/20190-Not allowed
298069949610/1/2020*0-Not allowed
29806994961/1/201412/31/20190-Not allowed
29806C89501/1/200612/31/20061-Allowed
29806C89521/1/200612/31/20061-Allowed
29806G03451/1/200512/31/20051-Allowed
29806G03471/1/200512/31/20051-Allowed
29806G03517/1/200512/31/20051-Allowed
29806G03537/1/200512/31/20051-Allowed
29806G03547/1/200512/31/20051-Allowed
29806G04637/1/2014*1-Allowed
29806G04717/1/2015*1-Allowed

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