How To Use CPT Code 23620

CPT code 23620 describes the closed treatment of a greater humeral tuberosity 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 23620?

CPT code 23620 is used to describe the closed treatment of a greater humeral tuberosity fracture without manipulation. This means that the healthcare provider performs a procedure to treat a crack in the greater tubercle, which is the rounded projection at the upper end of the humerus bone. The treatment does not involve adjusting or realigning the fractured bone.

2. Official Description

The official description of CPT code 23620 is: ‘Closed treatment of greater humeral tuberosity fracture without manipulation.’

3. Procedure

When performing the closed treatment of a greater humeral tuberosity fracture without manipulation, the healthcare provider follows these steps:

1. The patient is appropriately prepped for the procedure.
2. The provider assesses the fracture to ensure it appears clean and well aligned.
3. If the fracture meets the criteria, the provider proceeds with the closed treatment.
4. No manipulation or adjustment of the fractured bone is performed.
5. The patient is placed in a sling or brace for four to six weeks to aid in healing.
6. A follow-up X-ray examination may be performed to confirm the reduction of the fracture.

4. Qualifying circumstances

CPT code 23620 is used for patients with a greater humeral tuberosity fracture that does not require manipulation. This code is appropriate when the fracture appears clean and well aligned, as determined by a separately reportable X-ray. The treatment is performed by a healthcare provider and does not involve adjusting or realigning the fractured bone.

5. When to use CPT code 23620

CPT code 23620 should be used when the healthcare provider performs a closed treatment of a greater humeral tuberosity fracture without manipulation. If manipulation is involved in the treatment, a different code should be used. It is important to accurately document the procedure performed to ensure proper coding.

6. Documentation requirements

To support a claim for CPT code 23620, the healthcare provider must document the following information:

• Patient’s diagnosis of a greater humeral tuberosity fracture
• Description of the closed treatment procedure performed
• Date of the procedure
• Confirmation of fracture reduction, if applicable
• Use of a sling or brace for immobilization
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 23620, ensure that the procedure performed meets the criteria for closed treatment of a greater humeral tuberosity fracture without manipulation. It is important to accurately document the procedure and follow the appropriate coding guidelines. There are no specific guidelines regarding reporting CPT code 23620 with other codes.

8. Historical information

CPT code 23620 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A patient presents with a greater humeral tuberosity fracture. The healthcare provider performs a closed treatment without manipulation and immobilizes the patient’s arm in a sling for four weeks.
2. After a fall, a patient is diagnosed with a greater humeral tuberosity fracture. The healthcare provider performs a closed treatment without manipulation and instructs the patient to wear a brace for six weeks.
3. A patient sustains a greater humeral tuberosity fracture during a sports activity. The healthcare provider performs a closed treatment without manipulation and schedules a follow-up X-ray examination to confirm the reduction of the fracture.
4. Following a car accident, a patient is found to have a greater humeral tuberosity fracture. The healthcare provider performs a closed treatment without manipulation and prescribes pain medication for the patient.
5. A patient complains of shoulder pain and is diagnosed with a greater humeral tuberosity fracture. The healthcare provider performs a closed treatment without manipulation and recommends physical therapy to aid in the healing process.