How To Use CPT Code 23485

CPT code 23485 describes a procedure called osteotomy of the clavicle. 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 23485?

CPT code 23485 is used to describe the osteotomy of the clavicle procedure. This procedure involves the incision of a portion of the clavicle bone to repair poor clavicular alignment, fractures, or damage caused by arthritis. The procedure may also involve the use of a bone graft and internal fixation to ensure proper alignment and stability of the bone.

2. Official Description

The official description of CPT code 23485 is: ‘Osteotomy, clavicle, with or without internal fixation with bone graft for nonunion or malunion (includes obtaining graft and/or necessary fixation).’

3. Procedure

During the osteotomy of the clavicle procedure, the healthcare provider begins by making an incision over the clavicle bone. They then dissect through the subcutaneous tissue to access the bone. The provider removes a portion of the clavicle bone and may use implants such as screws, plates, or wires to fixate the bone in the desired alignment. If necessary, a bone graft is harvested from another part of the patient’s body through a separate incision. The bone graft is then used to further stabilize and support the clavicle bone. Finally, the provider sutures the soft tissue and closes the incisions.

4. Qualifying circumstances

CPT code 23485 is used for patients who require osteotomy of the clavicle to address nonunion or malunion of the bone. This procedure may be necessary for patients with poor clavicular alignment, fractures that have not healed properly, or damage caused by arthritis. The decision to perform the procedure is made by the healthcare provider based on the patient’s specific condition and symptoms.

5. When to use CPT code 23485

CPT code 23485 should be used when the healthcare provider performs an osteotomy of the clavicle procedure with or without internal fixation and bone graft for nonunion or malunion. It is important to accurately document the specific details of the procedure to support the use of this code.

6. Documentation requirements

To support a claim for CPT code 23485, the healthcare provider must document the following information:

• Patient’s diagnosis indicating the need for osteotomy of the clavicle
• Details of the procedure performed, including whether internal fixation and bone graft were used
• Date of the procedure
• Start and end time of the procedure
• Any additional procedures or services performed during the same session
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 23485, ensure that the procedure performed meets the criteria described in the official description. It is important to accurately document the details of the procedure to support the use of this code. Additionally, follow any specific billing guidelines provided by the payer or coding guidelines.

8. Historical information

CPT code 23485 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 23485

There are several similar codes to CPT code 23485 that may be used in different scenarios. These include:

• CPT 23480: Osteotomy, clavicle, with or without internal fixation
• CPT 23490: Osteotomy, clavicle, with or without internal fixation, with or without bone graft
• CPT 23491: Osteotomy, clavicle, with or without internal fixation, with or without bone graft; with dislocation or instability
• CPT 23500: Closed treatment of clavicular fracture; without manipulation
• CPT 23515: Open treatment of clavicular fracture, includes internal fixation, when performed

9. Examples

1. A patient with a nonunion clavicular fracture undergoes osteotomy of the clavicle with internal fixation and bone graft.
2. A patient with malunion of the clavicle due to poor alignment undergoes osteotomy of the clavicle without internal fixation but with bone graft.
3. A patient with arthritis in the clavicle undergoes osteotomy of the clavicle with internal fixation and bone graft to correct the damage.
4. A patient with a nonunion clavicular fracture undergoes osteotomy of the clavicle without internal fixation but with bone graft.
5. A patient with malunion of the clavicle due to poor alignment undergoes osteotomy of the clavicle with internal fixation but without bone graft.
6. A patient with arthritis in the clavicle undergoes osteotomy of the clavicle without internal fixation or bone graft.
7. A patient with a nonunion clavicular fracture undergoes osteotomy of the clavicle with internal fixation but without bone graft.
8. A patient with malunion of the clavicle due to poor alignment undergoes osteotomy of the clavicle without internal fixation or bone graft.
9. A patient with arthritis in the clavicle undergoes osteotomy of the clavicle with internal fixation and bone graft.
10. A patient with a nonunion clavicular fracture undergoes osteotomy of the clavicle without internal fixation or bone graft.