cpt code for shoulder replacement surgery

Jan 23 2018 Although it may not be the first thought or consideration insurance reimbursement must be understood prior to initiation of a program for outpatient shoulder arthroplasty Many if not most commercial contracts will include arthroplasty consisting of CPT codes 23472 23473 and 23474

Total shoulder replacement is a complex procedure that involves replacing the shoulder joint with artificial parts Our shoulder specialists have performed numerous shoulder replacements at Johns Hopkins and appreciate an opportunity to share their knowledge They have provided answers to

Shoulder arthroplasty also known as shoulder replacement surgery was first carried out in the United States in the 1950s for the treatment of severe glenohumeral joint fractures Over the years shoulder arthroplasty has been employed for the treatment of many other painful conditionsdiseases of the shoulder eg various forms of arthritis

Sep 13 2017 I work with some shoulder specialists who are disagreeing about if the glenoid grafting can be separately reported with their shoulders When doing a shoulder replacement they sometimes will do some grafting to the glenoid in order for the prosthesis to sit better

Shoulder Arthroplasty CPT 23472 Shoulder Arthroplasty ICD10 Codes M19011 Primary osteoarthritis right shoulder M19012 Primary osteoarthritis left shoulder M19019 Primary osteoarthritis unspecified shoulder Z471 Aftercare following joint replacement surgery Z4731 Aftercare following explantation of shoulder joint prosthesis

Nov 20 2013 The reverse shoulder arthroplasty CPT Code 23472 is a surgical procedure normally conducted for relieving pain caused by arthritis as well as massive rotator cuff tears Also known as the reverse shoulder replacement this operation has the ball of your shoulder joint where the socket should be and vice versa which is the reverse of your normal anatomy

Shoulder and Elbow Codes CPT Codes Common Procedures and proximal humeral replacement eg total shoulder 23472 Reverse Shoulder Arthroplasty 23472 23332 Revision Total Shoulder Arthroplasty Removal of foreign body shoulder complicated eg total shoulder Followup examination following surgery CPT CPT Long

Jan 27 2015 shoulder replacement surgery arthroplasty Health Plan of Nevada Jun 4 2012 Shoulder Replacement Surgery Arthroplasty COMMERCIAL MEDICARE MEDICAID COVERAGE RATIONALE It does not constitute DONT LET SHOULDER PAIN KEEP YOU OUT OF THE GAME shoulder replacement In all cases shoulder and elbow surgeon with the Henry

CPT Code Range Head 0010000222 Neck 0030000352 Thorax chest wall and shoulder girdle 01638 shoulder replacement 01650 shoulder artery surgery 01652 shoulder vessel surgery 01654 shoulder vessel surgery 01656 armleg vessel surgery 01670 shoulder vein surgery 01680 shoulder casting Upper Arm Elbow 01710 procedures on nerves

Professional Services Coding Forum Shoulder surgery addyhKlasinski November 2016 edited May 2017 in Orthopedics Sorry this is so long I am a new coder and a little confused about this one I am thinking 23420 for the open reconstruction of the rotator cuff including the acromioplasty 23120 for the excision of the distal clavicle And

Total shoulder replacement is a highly beneficial surgical procedure intended to reduce pain and restore mobility in patients with endstage shoulder arthritis and occasionally after certain severe shoulder fractures One year after surgery 95 of patients enjoy painfree function enabling them

Q What CPT code would you report when performing a reversal total shoulder arthroplasty A CPT will at times have one code that covers a particular procedure such as arthroplasty Different techniques are then developed to either enhance or strengthen the procedure But when it comes to coding the procedure is still considered an arthroplasty

It is considered an inclusive component of CPT code 29827 arthroscopy shoulder surgical with rotator cuff repair This code represents the repair of one two or three tendons and the number of portals made does not alter the use of this particular code

Shoulder replacement surgery typically costs 700021000 or more depending on the type of implants used and the hospital in which the procedure is performed According to a 2007 study by researchers from Johns Hopkins University a shoulder replacements total

The expert panel noted the immediate postservice time for the reference code 23472 Arthroplasty glenohumeral joint total shoulder nlenoid and proximal humeral replacement eg total shoulder is also 30 minutes 30 minutes falls within the range of immediate postservice time for 90day global procedures especially with respect to orthopaedic procedures

This type of surgery however is not as beneficial for patients with large rotator cuff tears who have developed a complex type of shoulder arthritis called cuff tear arthropathy For these patients conventional total shoulder replacement may result in pain and limited motion and reverse total shoulder replacement is a better option

Shoulder Replacement Surgery Arthroplasty Page 2 of 3 UnitedHealthcare Community Plan Medical Policy Effective 04012019 Proprietary Information of UnitedHealthcare

The surgery experience is very similar to that of a regular shoulder replacement with a few variations The main factor in the recovery is whether this is the first shoulder replacement for the shoulder or whether an old prosthesis has to be taken out during surgery

Are you scheduled to have shoulder replacement surgery Learn more about the procedure risks recovery time and what to expect

Shoulder replacement surgery is proven andor medically necessary in certain circumstances For applicable clinical coverage criteria see the following MCG Care Guidelines 22nd edition 2018 Shoulder Arthroplasty S634 ISC Shoulder Hemiarthroplasty S633 ISC APPLICABLE CODES

The reverse shoulder replacement uses a ballandsocket joint as well but the ball is placed on the shoulder blade and the socket is placed on top of the arm bone This is the reverse of our normal anatomy hence the name reverse shoulder replacement

For hemiarthroplasty of the shoulder there needs to be documentation as to why this procedure was performed There are three choices that are listed in the CPT book The problem is that most coders will choose code 23470 This reads Arthroplasty glenhumeral joint hemiarthroplasty

replacement surgery and revision 1 Arthroplasty wArthroplasty wReverse shoulder arthroplasty 24 Joint Replacement Coding AHIMA 2007 Audio Seminar Series 13 CPT Joint Replacement Coding AHIMA 2007 Audio Seminar Series 29 CPT

Hospital Outpatient and Ambulatory Surgery Center ASC CPT Code Description OPPS Status Indicator Ambulatory Payment Classification ASC Payment Indicator 23470 Arthroplasty glenohumeral joint hemiarthroplasty J1 5115 NA 23472 Arthroplasty glenohumeral joint total shoulder glenoid and proximal humeral replacement eg total shoulder C

Shoulder Arthroplasty is also routinely performed with stabilization of the Biceps tendon known as a Biceps Tenodesis this may be billed as a separate and additional CPT code 23430 Although this information can be confusing knowledge of these codes is helpful to patients in order to understand the foundation from which surgical billing is determined

Aug 30 2016 AAOS considers a biceps tenodesis separately reportable when performing a total shoulder however it is bundled in CCI so would not be reportable to Medicare or any government payors or anyone following Medicare CCI I however do not see documentation of the tenodesis

And 29822 RT 59 Arthroscopy shoulder surgical debridement limited distinct procedural service The problem with coding this is that 29822 bundles into 29827 and 29824 per NCCl edits and because it is the right shoulder for all procedures it would be inappropriate to use a modifier to bypass the bundling edit says Ms Keith

Feb 18 2012 Answer You should report 23472 Arthroplasty glenohumeral joint total shoulder glenoid and proximal humeral replacement eg total shoulder for the reverse total shoulder arthroplasty