Q&A: Extensive and limited shoulder debridement
Q: What’s the difference between extensive and limited debridement in the shoulder?
A: To stay compliant and ensure proper payment, coders must clearly understand the difference between the two types of debridement, based on the codes’ Current Procedural Terminology (CPT) descriptors:
- 29822, Arthroscopy, shoulder, surgical; debridement, limited, 1 or 2 discrete structures
- 29823, Arthroscopy, shoulder, surgical; debridement, extensive, 3 or more discrete structures
The CPT manual descriptions for each code makes it clear: if the surgeon debrides one to two “discrete structures” in the shoulder, it would be considered limited (29822). If three or more are debrided, it would be coded as extensive (29823). Both bone and soft tissue qualify as discrete structures, according to the codes’ descriptors.
Further, to qualify for codes 29822 and 29823, the surgeon must document which of the following structures were debrided:
- Humeral bone and humeral articular cartilage
- Glenoid bone and glenoid articular cartilage
- Biceps tendon, biceps anchor complex
- Labrum
- Articular capsule
- Articular side of the rotator cuff
- Bursal side of the rotator cuff
- Subacromial bursa
- Foreign body(ies)
The physician can support the need for an extensive debridement by clearly describing the conditions of the areas that required treatment and exactly what was done.
Editor’s note: This Q&A originally appeared in JustCoding. This information was excerpted from 2025 Orthopedic Coding & Documentation Trainer.