How To Use CPT Code 23184

CPT code 23184 describes the partial excision of bone in the proximal humerus, typically performed to treat 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 23184?

CPT 23184 is used to describe the partial excision of bone in the proximal humerus, which is the upper part of the upper arm. This procedure is typically performed to treat conditions such as osteomyelitis or abscess, where a portion of infected bone needs to be removed to facilitate drainage and promote healing.

2. Official Description

The official description of CPT code 23184 is: ‘Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), proximal humerus.’

3. Procedure

During the procedure, the healthcare provider begins by making an incision over the proximal humerus. They then dissect the muscles to access the infected portion of the bone. Using a bone cutting instrument, they carefully remove the infected bony tissue down to healthy tissues. In some cases, a saucer or crater-shaped depression may be left to aid in drainage. If necessary, a portion of the bone shaft, known as the diaphysis, may also be excised. The removed tissue is typically sent to a laboratory for analysis. The provider then inserts a drainage tube, irrigates the area with antibiotic solution, checks for bleeding, removes any instruments, and closes the incision.

4. Qualifying circumstances

CPT 23184 is typically performed on patients with conditions such as osteomyelitis or abscess in the proximal humerus. These conditions involve infection in the bone or the presence of a collection of pus. The procedure is performed by a healthcare provider who is qualified to perform bone excisions, such as a surgeon or orthopedic specialist.

5. When to use CPT code 23184

CPT code 23184 should be used when a partial excision of bone in the proximal humerus is performed to treat conditions such as osteomyelitis or abscess. It is important to ensure that the procedure is documented accurately and that the diagnosis supports the need for the excision.

6. Documentation requirements

To support a claim for CPT 23184, the healthcare provider must document the following information:

• Patient’s diagnosis, indicating the presence of osteomyelitis or abscess
• Details of the procedure, including the specific bone excised and any additional techniques used (e.g., craterization, saucerization, or diaphysectomy)
• Date of the procedure
• Any complications or unexpected findings
• Any specimens sent for analysis
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 23184, it is important to ensure that the procedure performed aligns with the description of the code. The healthcare provider should be qualified to perform bone excisions, and the procedure should be documented accurately. It is also important to follow any specific billing guidelines provided by the payer or coding guidelines.

8. Historical information

CPT code 23184 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 23184

There are several similar codes to CPT 23184 that describe excision procedures on the shoulder. These include:

• CPT 23065: Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm
• CPT 23066: Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); less than 5 cm
• CPT 23067: Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); 5 cm or greater
• CPT 23120: Excision, tumor, soft tissue of shoulder area, subcutaneous; 3 cm or greater
• CPT 23220: Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); 5 cm or greater

9. Examples

1. A patient with osteomyelitis in the proximal humerus undergoes a partial excision of the infected bone to facilitate drainage and promote healing.
2. An individual presents with an abscess in the proximal humerus, and a healthcare provider performs a partial excision to remove the infected tissue and promote healing.
3. A patient with a chronic infection in the proximal humerus requires a partial excision of the bone to address the underlying condition.
4. A healthcare provider performs a partial excision of the proximal humerus to treat a bone infection resulting from trauma or injury.
5. An individual with a history of osteomyelitis in the proximal humerus undergoes a partial excision of the bone to prevent further complications and promote healing.
6. A patient with an abscess in the proximal humerus undergoes a partial excision to remove the infected tissue and prevent the spread of infection.
7. An individual with a chronic bone infection in the proximal humerus requires a partial excision to address the underlying condition and promote healing.
8. A healthcare provider performs a partial excision of the proximal humerus to treat a bone infection resulting from a previous surgical procedure.
9. A patient with a history of osteomyelitis in the proximal humerus undergoes a partial excision of the bone to prevent recurrence and promote healing.
10. An individual with an abscess in the proximal humerus undergoes a partial excision to remove the infected tissue and alleviate symptoms.