How To Use CPT Code 23450

CPT code 23450 describes the capsulorrhaphy procedure, specifically the anterior Putti-Platt procedure or Magnuson type operation, performed to repair a tear in the shoulder joint capsule and tighten the joint capsule in cases of hyperlaxity. 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 23450?

CPT code 23450 is used to describe the capsulorrhaphy procedure, specifically the anterior Putti-Platt procedure or Magnuson type operation. This procedure is performed to repair a tear in the shoulder joint capsule and tighten the joint capsule in cases of hyperlaxity, which refers to excessive movement in an abnormal plane of movement for the shoulder. The purpose of this procedure is to treat conditions such as severe shoulder instability.

2. Official Description

The official description of CPT code 23450 is: ‘Capsulorrhaphy, anterior Putti-Platt procedure or Magnuson type operation.’

3. Procedure

During the capsulorrhaphy procedure, the healthcare provider repairs a tear in the patient’s shoulder joint capsule and tightens the joint capsule in cases of hyperlaxity. The procedure involves the following steps:

  1. The patient is appropriately prepped and anesthetized.
  2. The provider makes an incision over the shoulder joint and dissects through the subcutaneous tissue to expose the joint capsule.
  3. The upper and lower borders of the subscapularis tendon are visualized.
  4. The provider transects the subscapularis tendon down to the capsule and reflects the medial part of the tendon off the capsule until no additional connections exist between the tendon and the capsule.
  5. The provider explores and assesses the capsule and irrigates the area to remove loose bodies from the joint cavity.
  6. The capsule is divided vertically, midway between its attachments on the glenoid rim and the humeral head.
  7. Stay sutures are placed along the free edge of the medial capsular leaflet.
  8. The provider ensures that the capsule is appropriately tightened.
  9. All bleeding is stopped, a drain is placed, and the wound is closed by suturing the layers of tissue together.

4. Qualifying circumstances

CPT code 23450 is used for patients with severe shoulder instability and hyperlaxity, where there is excessive movement in an abnormal plane of movement for the shoulder. The procedure is performed to repair a tear in the shoulder joint capsule and tighten the joint capsule. The patient must meet the specific criteria for this procedure, as determined by the healthcare provider.

5. When to use CPT code 23450

CPT code 23450 should be used when the healthcare provider performs the capsulorrhaphy procedure, specifically the anterior Putti-Platt procedure or Magnuson type operation, to repair a tear in the shoulder joint capsule and tighten the joint capsule in cases of hyperlaxity. This code should be used for each instance of the procedure performed.

6. Documentation requirements

To support a claim for CPT code 23450, the healthcare provider must document the following information:

  • Patient’s diagnosis indicating severe shoulder instability and hyperlaxity
  • Description of the procedure performed, including whether it was the anterior Putti-Platt procedure or Magnuson type operation
  • Date of the procedure
  • Details of the surgical approach and technique used
  • Any additional procedures or interventions performed during the same operative session
  • Any complications or unexpected findings
  • Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 23450, ensure that the procedure performed is the capsulorrhaphy, specifically the anterior Putti-Platt procedure or Magnuson type operation. Follow the appropriate coding guidelines and ensure accurate documentation to support the claim. It is important to review the payer’s specific billing guidelines and requirements for proper reimbursement.

8. Historical information

CPT code 23450 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 23450

There are several similar codes to CPT code 23450 that are used to describe other repair, revision, and/or reconstruction procedures on the shoulder. Some similar codes include:

  • CPT 23395: Capsulorrhaphy, posterior (eg, reverse Putti-Platt, Bankart type)
  • CPT 23410: Capsulorrhaphy, posterior (eg, reverse Putti-Platt, Bankart type)
  • CPT 23412: Capsulorrhaphy, posterior (eg, reverse Putti-Platt, Bankart type); with rotator cuff repair
  • CPT 23415: Capsulorrhaphy, posterior (eg, reverse Putti-Platt, Bankart type); with labral repair (eg, SLAP or Bankart lesion)
  • CPT 23420: Capsulorrhaphy, posterior (eg, reverse Putti-Platt, Bankart type); with remplissage

9. Examples

  1. A patient with severe shoulder instability undergoes the anterior Putti-Platt procedure to repair a tear in the shoulder joint capsule and tighten the joint capsule.
  2. A patient with hyperlaxity in the shoulder joint undergoes the Magnuson type operation to address the excessive movement and stabilize the joint.
  3. A healthcare provider performs the capsulorrhaphy procedure on a patient with a tear in the shoulder joint capsule and hyperlaxity, using the anterior Putti-Platt technique.
  4. A patient with severe shoulder instability and hyperlaxity undergoes the capsulorrhaphy procedure, specifically the Magnuson type operation, to repair the tear in the joint capsule and tighten the joint.
  5. A healthcare provider performs the anterior Putti-Platt procedure on a patient with hyperlaxity in the shoulder joint, addressing the excessive movement and stabilizing the joint.

Similar Posts

Leave a Reply

Your email address will not be published. Required fields are marked *