How To Use CPT Code 23107

CPT code 23107 describes the surgical procedure known as arthrotomy of the glenohumeral joint. 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 23107?

CPT 23107 is a code used to describe the surgical procedure of arthrotomy of the glenohumeral joint. This procedure involves making an incision over the shoulder joint to gain access to the structures inside the joint. The purpose of this procedure is to inspect the joint and remove any loose material or foreign bodies that may be causing pain or limiting mobility.

2. Official Description

The official description of CPT code 23107 is: ‘Arthrotomy, glenohumeral joint, with joint exploration, with or without removal of loose or foreign body.’

3. Procedure

During the arthrotomy procedure, the healthcare provider begins by preparing the patient and administering anesthesia. Once the patient is appropriately prepped and anesthetized, the provider makes an incision over the glenohumeral joint and extends the incision down to the joint capsule. The joint capsule is then incised to gain access to the structures within the joint.

Once inside the joint, the provider carefully examines the structures, looking for any loose material or foreign bodies. If any are found, they are removed to relieve pain and restore mobility to the joint. The provider then irrigates the area, checks for bleeding, removes any instruments, and closes the incision.

4. Qualifying circumstances

Patients who may require arthrotomy of the glenohumeral joint are those who have conditions or injuries that affect the shoulder joint and have not responded to conservative treatments. This procedure may be necessary for patients with conditions such as shoulder osteoarthritis, rotator cuff tears, or shoulder instability.

5. When to use CPT code 23107

CPT code 23107 should be used when a healthcare provider performs an arthrotomy of the glenohumeral joint, with or without the removal of loose or foreign bodies. This code is appropriate when the provider makes an incision over the shoulder joint, explores the joint, and performs any necessary removal of loose or foreign material.

6. Documentation requirements

To support a claim for CPT code 23107, the healthcare provider must document the following information:

• Patient’s diagnosis or condition necessitating the arthrotomy procedure
• Description of the procedure performed, including the incision, exploration of the joint, and removal of any loose or foreign bodies
• Date of the procedure
• Any complications or unexpected findings during the procedure
• Post-procedure instructions or recommendations
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 23107, it is important to ensure that the procedure performed meets the criteria outlined in the code description. The provider should document the necessary details to support the use of this code, including the exploration of the joint and any removal of loose or foreign bodies.

It is also important to follow any specific billing guidelines provided by the payer or insurance company. This may include using appropriate modifiers or providing additional documentation if requested.

8. Historical information

CPT code 23107 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Similar codes to CPT 23107

There are several similar codes to CPT code 23107 that describe other procedures on the shoulder. These include:

• CPT 23065: Arthrotomy, shoulder, with exploration, drainage, or removal of foreign body or loose body
• CPT 23066: Arthrotomy, shoulder, with synovectomy
• CPT 23075: Arthrotomy, shoulder, with capsular repair
• CPT 23100: Excision of shoulder joint capsule
• CPT 23220: Excision of lesion of joint capsule or ligament, shoulder; extensive (eg, capsular shift or release, debridement)

9. Examples

1. A patient with shoulder osteoarthritis undergoes arthrotomy of the glenohumeral joint to remove loose cartilage fragments.
2. An individual with a history of shoulder dislocations undergoes arthrotomy to explore the joint and repair any damaged structures.
3. A patient with a suspected foreign body in the shoulder joint undergoes arthrotomy to remove the foreign object.
4. A professional athlete with a rotator cuff tear undergoes arthrotomy to assess the extent of the injury and repair the torn tendon.
5. A patient with adhesive capsulitis (frozen shoulder) undergoes arthrotomy to release the tight joint capsule and improve range of motion.
6. An individual with recurrent shoulder infections undergoes arthrotomy to drain the infected fluid and remove any abscesses.
7. A patient with a suspected tumor in the shoulder joint undergoes arthrotomy to obtain a biopsy for further evaluation.
8. An individual with a history of shoulder trauma undergoes arthrotomy to assess the damage and repair any torn ligaments or tendons.
9. A patient with shoulder impingement syndrome undergoes arthrotomy to remove bone spurs and relieve pressure on the rotator cuff tendons.
10. An individual with a chronic shoulder infection undergoes arthrotomy to remove infected tissue and promote healing.