How To Use CPT Code 23490

CPT code 23490 describes the prophylactic treatment of a clavicle defect using fixation implants such as nails, plates, or screws, with or without the use of methylmethacrylate. 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 23490?

CPT 23490 is used to describe the prophylactic treatment of a defect in the clavicle, or collar bone, using fixation implants such as nails, plates, or screws. This procedure aims to prevent further problems and may involve the use of methylmethacrylate, a type of bone cement, for additional stability.

2. Official Description

The official description of CPT code 23490 is: ‘Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate clavicle.’

3. Procedure

In this procedure, the healthcare provider treats a defect in the clavicle using fixation implants such as nails, plates, or screws. The patient is appropriately prepped and anesthetized, and the provider makes an incision just above the defect in the clavicle bone. They then dissect down through the subcutaneous tissue to the bone, retracting the nerve and muscle tissue in the area.

The provider then uses the chosen fixation implants to fix the defect in the bone and stabilize it. They may also take an X-ray to verify proper fixation. If necessary, they may use methylmethacrylate, a type of bone cement, to fill the defect and provide extra stability. Finally, they stop any bleeding at the surgical site and close the wound by suturing the soft tissue in layers.

4. Qualifying circumstances

CPT 23490 is performed when there is a defect in the clavicle that requires prophylactic treatment. The use of fixation implants and, if necessary, methylmethacrylate, is determined by the provider based on the specific needs of the patient. The procedure is typically performed to prevent further problems or complications related to the clavicle defect.

5. When to use CPT code 23490

CPT code 23490 should be used when a healthcare provider performs prophylactic treatment for a defect in the clavicle using fixation implants such as nails, plates, or screws. The use of methylmethacrylate may or may not be involved, depending on the specific circumstances of the case.

6. Documentation requirements

To support a claim for CPT 23490, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for prophylactic treatment
• Specific fixation implants used
• Use of methylmethacrylate, if applicable
• Date of the procedure
• Details of the procedure, including incision, fixation, and closure
• Any X-rays taken to verify proper fixation
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 23490, ensure that the procedure meets the criteria for prophylactic treatment of a clavicle defect using fixation implants. If methylmethacrylate is used, it should be documented accordingly. There are no specific guidelines regarding reporting CPT 23490 with other codes.

8. Historical information

CPT 23490 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 23490

Five similar codes to CPT 23490 include:

• CPT 23395: Repair of clavicle fracture or dislocation
• CPT 23491: Revision or removal of clavicle fixation
• CPT 23500: Closed treatment of clavicle fracture
• CPT 23515: Open treatment of clavicle fracture, with or without internal or external fixation
• CPT 23570: Closed treatment of clavicle dislocation

9. Examples

1. A patient with a clavicle defect undergoes prophylactic treatment using plates and screws to stabilize the bone.
2. A healthcare provider performs prophylactic treatment for a clavicle defect using nails and methylmethacrylate for additional stability.
3. A patient with a clavicle defect receives prophylactic treatment with the use of plates, screws, and methylmethacrylate.
4. A healthcare provider performs prophylactic treatment for a clavicle defect using pins and plates without the use of methylmethacrylate.
5. A patient undergoes prophylactic treatment for a clavicle defect using screws and methylmethacrylate for stabilization.
6. A healthcare provider performs prophylactic treatment for a clavicle defect using nails and plates without the use of methylmethacrylate.
7. A patient with a clavicle defect receives prophylactic treatment using screws and methylmethacrylate for additional stability.
8. A healthcare provider performs prophylactic treatment for a clavicle defect using plates and screws without the use of methylmethacrylate.
9. A patient undergoes prophylactic treatment for a clavicle defect using nails and methylmethacrylate for stabilization.
10. A healthcare provider performs prophylactic treatment for a clavicle defect using pins and plates with the use of methylmethacrylate for additional stability.