Arthroscopic Biceps Tenotomy

Question:

We are having a debate in our practice on the proper CPT code for an arthroscopic biceps tenotomy.  We have seen some sources state that an arthroscopic bicep tenotomy is considered a debridement and billed under 29822/29823. Others reference CPT 29999 as it seems more like a release and not a debridement. Is there a clear answer on why an arthroscopic bicep tenotomy is considered a debridement and is it correct to be billing 29822 versus 29999?

Answer:

Thank you for your question, coding for an arthroscopic biceps tenotomy has been disputed for many years.  CPT Assistant January 2018 confirms that an arthroscopic biceps tenotomy is coded to the arthroscopic debridement codes, 29822/29823, depending upon how many other distinct structures are debrided. 

Remember if an arthroscopic biceps tenotomy is performed during the same operative session as an arthroscopic or open biceps tenodesis, only the biceps tenodesis would be coded. 

*This response is based on the best information available as of 08/06/26.

17110 for AK?

Question:

Is 17110 appropriate for using liquid nitrogen for irritated actinic keratoses?

Answer:

No — 17110 is not the correct destruction code for actinic keratoses.

Destruction of actinic keratoses should be reported as follows:

• 17000 for the first lesion

• 17003 for each additional lesion (for lesions 2–14)

• 17004 when 15 or more lesions are treated

Documentation should clearly include the method of destruction, the location of each lesion, and the total number treated.

Thank you for reaching out to KZA!

*This response is based on the best information available as of 08/06/26.

Instrumentation for CPT 69210

Question:

For CPT 69210, is suction, by itself, considered instrumentation for this procedure code?

Answer:

According to the AAO-HNS, using CPT code 69210 is reported based on what instruments are used to remove the impacted ear wax.  Instrumentation is defined as the use of an otoscope and instruments such as wax curettes, wire, loops or suction specific ear instruments (e.g., cup loops, right angle hook) or a similar tool designed for controlled wax extraction. Documentation should indicate the equipment used to provide the service.  

*This response is based on the best information available as of 07/16/26.

Pilonidal Disease Excision

Question:

I frequently perform adjacent tissue transfers (CPT 14000, 14001, 14020). When I excise pilonidal disease (CPT 11770, 11771, 11772) and then perform an adjacent tissue transfer, can I report both the excision and the tissue transfer codes, or is only the tissue transfer separately billable?

Additionally, in cases where I excise a malignant lesion (CPT 11604, 11606) and close the defect with an adjacent tissue transfer, my understanding is that only the adjacent tissue transfer code (e.g., 14000) is reportable, and the excision is considered included. Is this correct?

Answer:

This is a great question. Even though pilonidal excision is a “disease excision” rather than a lesion excision, CPT still treats the excision as included in the ATT. If you excise pilonidal disease and close with an adjacent tissue transfer (e.g., Limberg flap, Karydakis flap, Z-plasty), you bill only the ATT code (14000–14001–14020 etc.). Keep in mind when you perform an adjacent tissue transfer to close a defect, you do NOT separately bill the excision of a lesion (benign or malignant).

The ATT includes:

• Creating the defect (whether by trauma or excision)

• Preparing the wound bed

• Closing the defect with the flap

The excision is considered included in the ATT code.

This applies to:

• Benign lesion excision (11400 series)

• Malignant lesion excision (11600 series)

• Benign cyst excision (e.g., pilonidal disease 11770–11772)

• Scar revision excision

• Any excision that results in the defect you are closing with ATT

*This response is based on the best information available as of 07/16/26.

Laparoscopic Male Sling

Question:

What is the CPT code for robotic-assisted laparoscopic male sling using an in situ vascularized peritoneal flap? Is CPT 51992 applicable or is this specific for female genital system?

Answer:

CPT 51992 is not a gender-specific code; therefore, it can be reported for patients of any gender.

This is further supported by the CPT Knowledge Base response published on 4/8/2013 that recommends reporting CPT 51992 with prostatectomy CPT 55866.

*This response is based on the best information available as of 07/16/26.

Hill Sachs Lesion

Question:

I'm specifically looking for guidance on how to code for a repair of a humeral head Hill Sachs lesion when done with arthroscopic Bankart repair or SLAP repair.

Answer:

Repairing the Hill Sachs lesion, bony defect in the humeral head, is typically performed along with a Bankart repair, with the addition of filling in the defect with the rotator cuff tendon. There are several different references on how to correctly code for this. CPT Assistant July 2015 states to code an Arthroscopic Bankart Repair with a repair of the Hill Sachs lesion by appending modifier 22 to the Bankart repair, 29806-22. The same guidance would apply for an Arthroscopic SLAP lesion repair with a Hill Sachs lesion, CPT 29807-22.

*This response is based on the best information available as of 07/09/26.