How To Use CPT Code 23470

CPT code 23470 describes the procedure of glenohumeral joint hemiarthroplasty, which involves replacing the damaged head of the humerus with a prosthetic implant while leaving the glenoid cavity intact. 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 23470?

CPT code 23470 is used to describe the procedure of glenohumeral joint hemiarthroplasty. This procedure involves replacing the damaged head of the humerus with a prosthetic implant while leaving the glenoid cavity intact. It is performed when arthritis only affects the humerus head of the shoulder joint.

2. Official Description

The official description of CPT code 23470 is: ‘Arthroplasty, glenohumeral joint hemiarthroplasty.’

3. Procedure

During the glenohumeral joint hemiarthroplasty procedure, the healthcare provider performs the following steps:

1. The patient is appropriately prepped and anesthetized.
2. The provider makes an incision across the front of the shoulder, from the middle of the collarbone to the middle of the arm bone.
3. The provider dissects down through the subcutaneous tissue to access the joint.
4. The muscles, nerves, and blood vessels are retracted.
5. The provider incises the joint capsule and dislocates the glenohumeral joint to remove the damaged head of the humerus from the glenoid socket.
6. Any loose bodies present in the joint cavity are removed.
7. The damaged head of the humerus is incised using an osteotome.
8. A prosthetic humeral head implant stem is placed into the humerus shaft by drilling into the medullary canal.
9. The prosthetic humeral head is aligned correctly and reduced into the glenoid cavity.
10. The muscle around the joint is sutured to provide stabilization.
11. Osteophytes around the joint are removed.
12. Bleeding is controlled, drains are placed if necessary, and the wound is closed by suturing the layers of tissue.
13. A brace or sling is applied to immobilize the shoulder for four to six weeks to aid in healing.

4. Qualifying circumstances

Glenohumeral joint hemiarthroplasty is performed on patients with arthritis that specifically affects the humerus head of the shoulder joint. The procedure is indicated when conservative treatments have failed to provide relief and the patient’s quality of life is significantly impacted. The decision to perform this procedure is made by the healthcare provider based on the patient’s individual circumstances and medical history.

5. When to use CPT code 23470

CPT code 23470 should be used when the healthcare provider performs glenohumeral joint hemiarthroplasty, replacing the damaged head of the humerus with a prosthetic implant while leaving the glenoid cavity intact. This code is specific to this procedure and should not be used for other types of shoulder arthroplasty.

6. Documentation requirements

To support a claim for CPT code 23470, the healthcare provider must document the following information:

• Patient’s diagnosis and indication for glenohumeral joint hemiarthroplasty
• Description of the procedure performed, including any specific techniques or modifications
• Date of the procedure
• Start and end time of the procedure
• Any additional procedures or interventions performed during the same session
• Any complications or unexpected findings
• Post-operative care instructions
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 23470, ensure that the procedure performed is glenohumeral joint hemiarthroplasty. This code should not be reported for other types of shoulder arthroplasty procedures. It is important to follow the specific documentation requirements and guidelines provided by the payer to ensure accurate and appropriate billing.

8. Historical information

CPT code 23470 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 23470

There are no similar codes to CPT code 23470 within the range of repair, revision, and/or reconstruction procedures on the shoulder (23395-23491).

9. Examples

1. A patient with severe arthritis in the humerus head undergoes glenohumeral joint hemiarthroplasty to alleviate pain and improve shoulder function.
2. A healthcare provider performs glenohumeral joint hemiarthroplasty on a patient who sustained a traumatic injury resulting in significant damage to the humerus head.
3. A patient with a history of failed conservative treatments for shoulder arthritis undergoes glenohumeral joint hemiarthroplasty to improve their quality of life.
4. A healthcare provider performs glenohumeral joint hemiarthroplasty on a patient with a congenital condition that affects the humerus head and causes chronic pain and limited mobility.
5. A patient with a history of recurrent shoulder dislocations undergoes glenohumeral joint hemiarthroplasty to stabilize the joint and prevent further dislocations.
6. A healthcare provider performs glenohumeral joint hemiarthroplasty on a patient with a history of failed previous shoulder surgeries to address persistent pain and dysfunction.
7. A patient with a history of shoulder osteonecrosis undergoes glenohumeral joint hemiarthroplasty to replace the necrotic humerus head and restore joint function.
8. A healthcare provider performs glenohumeral joint hemiarthroplasty on a patient with a tumor in the humerus head that requires surgical removal and reconstruction.
9. A patient with a history of shoulder infections and chronic inflammation undergoes glenohumeral joint hemiarthroplasty to remove the diseased humerus head and restore joint health.