How To Use CPT Code 23500
CPT 23500 describes the closed treatment of a clavicular fracture without manipulation. 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 23500?
CPT 23500 is used to describe the closed treatment of a clavicular fracture without manipulation. This means that the provider performs a procedure to treat a crack in the clavicle, or collarbone, without adjusting or manipulating the fractured bone. The treatment typically involves placing the patient in a sling or brace for four to six weeks to aid in healing.
2. Official Description
The official description of CPT code 23500 is: ‘Closed treatment of clavicular fracture without manipulation.’
3. Procedure
In the procedure for CPT 23500, the provider performs closed treatment of a clavicular bone fracture without manipulating the fractured bone. This involves assessing the fracture to ensure it appears clean and well aligned, as confirmed by a separately reportable X-ray. The provider then immobilizes the fracture by placing the patient in a sling or brace for a period of four to six weeks. Additional X-rays may be performed to confirm the reduction of the fracture.
4. Qualifying circumstances
CPT 23500 is appropriate for patients with a clavicular fracture that does not require manipulation or surgery. The provider must determine that the fracture appears clean and well aligned, as confirmed by a separately reportable X-ray. The patient may be placed in a sling or brace for four to six weeks to aid in healing.
5. When to use CPT code 23500
CPT code 23500 should be used when the provider performs closed treatment of a clavicular fracture without manipulation. If the provider adjusts the ends of the fractured clavicle back into their normal position, CPT code 23505 should be used instead.
6. Documentation requirements
To support a claim for CPT 23500, the provider must document the following information:
- Patient’s diagnosis of a clavicular fracture
- Confirmation of a clean and well-aligned fracture through a separately reportable X-ray
- Date of the procedure
- Start and end time of the procedure
- Details of the closed treatment performed
- Use of a sling or brace for immobilization
- Any additional X-rays performed to confirm reduction of the fracture
7. Billing guidelines
When billing for CPT 23500, ensure that the procedure performed is closed treatment of a clavicular fracture without manipulation. It is important to use the appropriate code based on the specific treatment provided. If manipulation is performed, CPT code 23505 should be used instead. It is also important to follow any additional guidelines provided by the payer or coding guidelines.
8. Historical information
CPT 23500 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 23500
There are several similar codes to CPT 23500 that describe different procedures for clavicular fractures. These include:
- CPT 23505: Closed treatment of clavicular fracture with manipulation
- CPT 23515: Closed treatment of clavicular fracture with skeletal traction and/or with local infiltration of anesthetic for fracture reduction
- CPT 23520: Closed treatment of clavicular fracture with insertion of intramedullary implant, with or without cerclage
- CPT 23525: Closed treatment of clavicular fracture with open reduction and internal fixation
- CPT 23530: Open treatment of clavicular fracture, includes internal fixation, when performed
9. Examples
- A patient presents with a clavicular fracture that appears clean and well aligned on an X-ray. The provider performs closed treatment by placing the patient in a sling for four weeks. CPT code 23500 should be used.
- A patient with a clavicular fracture requires manipulation to adjust the ends of the fractured bone back into their normal position. The provider performs this procedure and then immobilizes the fracture with a sling. CPT code 23505 should be used.
- A patient with a clavicular fracture undergoes closed treatment with skeletal traction and local infiltration of anesthetic for fracture reduction. CPT code 23515 should be used.
- A patient with a clavicular fracture undergoes closed treatment with the insertion of an intramedullary implant. CPT code 23520 should be used.
- A patient with a clavicular fracture undergoes closed treatment with open reduction and internal fixation. CPT code 23525 should be used.
