How To Use CPT Code 23335

CPT code 23335 describes the removal of a prosthesis involving both the humeral and glenoid areas of the shoulder. 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 23335?

CPT code 23335 is used to report the removal of a prosthesis that involves both the humeral and glenoid areas of the shoulder. This procedure may also include debridement and synovectomy if necessary. It is important to note that this code should not be reported if a prosthesis is being removed and replaced in the same shoulder during the same surgical session.

2. Official Description

The official description of CPT code 23335 is: ‘Removal of prosthesis, includes debridement and synovectomy when performed humeral and glenoid components (eg, total shoulder).’ It is important to note that this code should not be reported if a prosthesis is being removed and replaced in the same shoulder during the same surgical session. Additionally, if the removal of hardware other than the humeral and/or glenoid prosthesis is being performed, CPT code 20680 should be used.

3. Procedure

The procedure for CPT code 23335 involves the following steps:

1. The patient is prepped and anesthetized.
2. An incision is made to reach the prosthesis.
3. If necessary, debridement and removal of inflamed synovial or scar tissue is performed.
4. The prosthesis is removed using the appropriate extraction instruments.
5. The wound is irrigated and local anesthetic is applied.
6. The wound is closed in layers.

4. Qualifying circumstances

CPT code 23335 is used when a prosthesis involving both the humeral and glenoid areas of the shoulder is being removed. It may also include debridement and synovectomy if necessary. It is important to note that this code should not be reported if a prosthesis is being removed and replaced in the same shoulder during the same surgical session.

5. When to use CPT code 23335

CPT code 23335 should be used when a prosthesis involving both the humeral and glenoid areas of the shoulder is being removed. It is important to note that this code should not be reported if a prosthesis is being removed and replaced in the same shoulder during the same surgical session.

6. Documentation requirements

To support a claim for CPT code 23335, the following documentation is required:

• Patient’s diagnosis and indication for prosthesis removal
• Details of the procedure performed, including debridement and synovectomy if applicable
• Date of the procedure
• Start and end time of the procedure
• Any additional relevant information, such as complications or unexpected findings
• Signature of the performing physician

7. Billing guidelines

When billing for CPT code 23335, it is important to ensure that the procedure involves the removal of a prosthesis involving both the humeral and glenoid areas of the shoulder. This code should not be reported if a prosthesis is being removed and replaced in the same shoulder during the same surgical session. Additionally, if the removal of hardware other than the humeral and/or glenoid prosthesis is being performed, CPT code 20680 should be used.

8. Historical information

CPT code 23335 was added to the Current Procedural Terminology system on January 1, 2014. It was initially included in the Inpatient Only (IPO) list in 2017, but was later removed from the list in 2021. However, it was added back to the IPO list in 2022.

9. Examples

1. A patient undergoes the removal of a total shoulder prosthesis involving both the humeral and glenoid areas.
2. A surgeon performs the removal of a humeral and glenoid prosthesis, along with debridement and synovectomy.
3. A patient with a failed shoulder prosthesis undergoes the removal of the prosthesis and subsequent revision surgery.
4. A prosthesis is removed from a patient’s shoulder due to infection, and debridement and synovectomy are performed.
5. A patient with a dislocated shoulder prosthesis undergoes the removal of the prosthesis and repair of the surrounding tissues.
6. A surgeon removes a failed shoulder prosthesis and performs debridement and synovectomy to address inflammation and tissue damage.
7. A patient with a painful shoulder prosthesis undergoes the removal of the prosthesis and subsequent pain management interventions.
8. A prosthesis is removed from a patient’s shoulder due to mechanical failure, and debridement and synovectomy are performed to address associated complications.
9. A surgeon removes a shoulder prosthesis that has become loose, and performs debridement and synovectomy to optimize the patient’s outcome.
10. A patient with a shoulder prosthesis experiences recurrent infections, leading to the removal of the prosthesis and debridement of infected tissues.