How To Use CPT Code 23182

CPT code 23182 describes the partial excision of the scapula, specifically the bone, for conditions such as osteomyelitis or abscess. 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 23182?

CPT 23182 is used to describe the partial excision of the scapula bone, also known as the shoulder blade. This procedure is typically performed to address conditions such as osteomyelitis or abscess in the scapula. The provider removes a portion of the infected bone, creating a saucer or crater-shaped depression to facilitate drainage and promote healing.

2. Official Description

The official description of CPT code 23182 is: ‘Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), scapula.’

3. Procedure

During the procedure for CPT code 23182, the provider begins by making an incision over the scapula. They then dissect the surrounding muscles to access the infected portion of the bone. Using a bone cutting instrument, the provider carefully removes the infected bony tissue down to healthy tissues. They create a saucer or crater-shaped depression to aid in drainage. If necessary, the provider may also remove a portion of the bone shaft, known as the diaphysis. The excised bone tissue is typically sent to a laboratory for analysis. After excision, the provider inserts a drainage tube and irrigates the area with antibiotic solution. They check for any bleeding, remove any instruments, and close the incision.

4. Qualifying circumstances

CPT code 23182 is used for patients who require partial excision of the scapula bone due to conditions such as osteomyelitis or abscess. These conditions involve infection in the bone, leading to the need for surgical intervention. The procedure is typically performed by a qualified healthcare professional who has the necessary expertise in bone excision procedures. It is important to note that any additional procedures, such as incision and drainage or debridement of soft tissue abscesses, would be considered part of the base procedure and should not be separately reported.

5. When to use CPT code 23182

CPT code 23182 should be used when a partial excision of the scapula bone is performed for conditions such as osteomyelitis or abscess. It is important to ensure that the procedure aligns with the official description and meets the necessary qualifying circumstances. If the procedure involves other additional interventions, such as bone grafting, it should be reported separately.

6. Documentation requirements

To support a claim for CPT code 23182, the healthcare professional must document the following information:

• Patient’s diagnosis, indicating the presence of osteomyelitis or abscess
• Details of the procedure, including the specific technique used (craterization, saucerization, or diaphysectomy)
• Date of the procedure
• Start and end time of the procedure
• Any additional procedures performed during the same session
• Results of any laboratory analysis of the excised bone tissue
• Any complications or unexpected findings
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT code 23182, it is important to ensure that the procedure aligns with the official description and meets the necessary qualifying circumstances. The procedure should be performed by a qualified healthcare professional with expertise in bone excision procedures. It is also important to note that any additional procedures, such as bone grafting, should be reported separately. It is recommended to review the specific billing guidelines provided by the payer to ensure accurate and appropriate reporting of CPT code 23182.

8. Historical information

CPT code 23182 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 23182

There are several similar codes to CPT code 23182 that are used to describe excision procedures on the shoulder. These include:

• CPT 23065: Excision, tumor, soft tissue of shoulder area, subcutaneous
• CPT 23066: Excision, tumor, soft tissue of shoulder area, deep
• CPT 23075: Excision, tumor, bone of shoulder area
• CPT 23100: Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular)
• CPT 23220: Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); deep

9. Examples

1. A patient with osteomyelitis in the scapula undergoes a partial excision (23182) to remove the infected bone and facilitate drainage.
2. A provider performs a saucerization (23182) of an abscess in the scapula to promote healing and prevent further infection.
3. For a patient with a deep bone infection in the scapula, the provider performs a diaphysectomy (23182) to remove the infected portion of the bone.
4. A partial excision (23182) is performed on a patient with a chronic abscess in the scapula to alleviate symptoms and promote healing.
5. A provider performs a craterization (23182) of an osteomyelitis site in the scapula to aid in drainage and facilitate healing.
6. For a patient with a recurrent abscess in the scapula, the provider performs a partial excision (23182) to remove the infected bone and prevent further infection.
7. A saucerization (23182) is performed on a patient with a deep abscess in the scapula to promote drainage and facilitate healing.
8. A provider performs a diaphysectomy (23182) on a patient with osteomyelitis in the scapula to remove the infected bone and prevent further complications.
9. A partial excision (23182) is performed on a patient with a chronic abscess in the scapula to alleviate symptoms and promote healing.