How To Use CPT Code 23066

CPT code 23066 describes the procedure for a deep soft tissue biopsy of the shoulder area. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 23066?

CPT 23066 is used to describe the biopsy of deep soft tissue in the shoulder area. This procedure is performed to determine whether the cells in the patient’s shoulder are malignant, benign, or precancerous. It involves the removal of a portion or the entirety of suspicious tissue for laboratory examination.

2. Official Description

The official description of CPT code 23066 is: ‘Biopsy, soft tissue of shoulder area deep.’

3. Procedure

During the procedure for CPT 23066, the patient is appropriately prepped and the area is anesthetized. The healthcare provider makes an incision over the lump in the shoulder area and extends it through the fascia and/or muscle. Microdissection is then used to excise a sample of the deep soft tissue. The excised tissue is submitted for analysis. The provider irrigates the wound area and closes the incision with sutures.

4. Qualifying circumstances

CPT 23066 is performed when there is a need to biopsy the deep soft tissue of the shoulder area. This procedure is typically done when a lump or suspicious tissue is found under the patient’s skin, and an excisional biopsy is required to determine the nature of the lump. It is important to note that if a needle biopsy is performed instead of an excisional biopsy, CPT code 20206 should be reported.

5. When to use CPT code 23066

CPT code 23066 should be used when a healthcare provider performs a deep soft tissue biopsy of the shoulder area. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 23066, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for the biopsy
• Details of the procedure, including the incision, excision of tissue, and closure
• Any complications or additional procedures performed
• Results of the biopsy, if available
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 23066, ensure that the procedure meets the specific criteria outlined in the code description. It is important to follow the appropriate coding guidelines and modifiers, if applicable. Additionally, consider any specific billing requirements from the payer or insurance company.

8. Historical information

CPT 23066 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Similar codes to CPT 23066

There are several similar codes to CPT 23066 that are used for different types of biopsies. These include:

• CPT 23065: Biopsy, soft tissue of shoulder area superficial
• CPT 23100: Biopsy, soft tissue of shoulder area subcutaneous
• CPT 23101: Biopsy, soft tissue of shoulder area deep, subfascial (eg, intramuscular)
• CPT 23105: Biopsy, soft tissue of shoulder area subfascial (eg, intramuscular)
• CPT 23220: Biopsy, soft tissue of shoulder area, open incisional

9. Examples

1. A patient presents with a suspicious lump in their shoulder. The healthcare provider performs a deep soft tissue biopsy using CPT code 23066 to determine the nature of the lump.
2. During a routine examination, a healthcare provider discovers a mass in a patient’s shoulder. They perform a deep soft tissue biopsy using CPT code 23066 to evaluate the mass.
3. A patient with a history of cancer experiences new symptoms in their shoulder. The healthcare provider performs a deep soft tissue biopsy using CPT code 23066 to assess the presence of cancer cells.
4. Following an imaging study, a healthcare provider identifies an abnormality in a patient’s shoulder. They perform a deep soft tissue biopsy using CPT code 23066 to investigate the abnormality further.
5. A patient presents with persistent pain in their shoulder. The healthcare provider performs a deep soft tissue biopsy using CPT code 23066 to determine the cause of the pain.
6. During a surgical procedure on a patient’s shoulder, the healthcare provider identifies an area of concern and performs a deep soft tissue biopsy using CPT code 23066 to evaluate the tissue.
7. A patient with a history of shoulder injury develops a new lump. The healthcare provider performs a deep soft tissue biopsy using CPT code 23066 to assess the lump.
8. Following a physical examination, a healthcare provider suspects a tumor in a patient’s shoulder. They perform a deep soft tissue biopsy using CPT code 23066 to confirm the diagnosis.
9. A patient with a family history of cancer presents with a lump in their shoulder. The healthcare provider performs a deep soft tissue biopsy using CPT code 23066 to evaluate the lump for malignancy.
10. During a follow-up visit, a healthcare provider discovers a new growth in a patient’s shoulder. They perform a deep soft tissue biopsy using CPT code 23066 to determine the nature of the growth.