How To Use CPT Code 23650

CPT 23650 describes the closed treatment of a shoulder joint dislocation with manipulation, without the use of anesthesia. 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 23650?

CPT 23650 is used to describe the closed treatment of a shoulder joint dislocation with manipulation, without the use of anesthesia. This procedure involves the provider manually adjusting the separated bones of the shoulder joint to bring it back to its normal alignment. It is important to note that this code should only be used when anesthesia is not required for the manipulation.

2. Official Description

The official description of CPT code 23650 is: ‘Closed treatment of shoulder dislocation, with manipulation without anesthesia.’

3. Procedure

During the procedure, the provider first performs an X-ray to examine the dislocated shoulder joint. This helps in assessing the extent of the dislocation and planning the manipulation. The provider then manually adjusts the bones by gently pushing or pulling on the shoulder blade and arm to bring the shoulder joint back to its normal alignment. After the manipulation, the provider may place the shoulder joint in a sling or brace to immobilize it and aid in the healing process. Another X-ray may be performed to confirm the reduction of the dislocation.

4. Qualifying circumstances

CPT 23650 is used for patients who have a shoulder joint dislocation that requires closed treatment with manipulation, and anesthesia is not necessary for the procedure. It is important to note that if anesthesia is required for the manipulation, a different CPT code should be used.

5. When to use CPT code 23650

CPT code 23650 should be used when the provider performs a closed treatment of a shoulder joint dislocation with manipulation, without the use of anesthesia. If anesthesia is required for the manipulation, a different CPT code should be used.

6. Documentation requirements

To support a claim for CPT 23650, the provider must document the following information:

• Patient’s diagnosis of shoulder joint dislocation
• Confirmation of the need for closed treatment with manipulation
• Date of the procedure
• Details of the manipulation technique used
• Confirmation of reduction of the dislocation
• Placement of the shoulder joint in a sling or brace, if applicable
• Any additional X-rays performed

7. Billing guidelines

When billing for CPT 23650, ensure that the procedure involves closed treatment of a shoulder joint dislocation with manipulation, without the use of anesthesia. It is important to use the appropriate CPT code based on the specific circumstances of the procedure. If anesthesia is required for the manipulation, a different CPT code should be used.

8. Historical information

CPT 23650 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 23650

There are several similar codes to CPT 23650 that describe different procedures for the treatment of shoulder joint dislocations. These include:

• CPT 23655: Closed treatment of shoulder dislocation, with manipulation requiring anesthesia
• CPT 23660: Closed treatment of shoulder dislocation, with fracture manipulation, with or without skeletal traction
• CPT 23665: Closed treatment of shoulder dislocation, with fracture manipulation, with or without skeletal traction; requiring anesthesia
• CPT 23670: Closed treatment of shoulder dislocation, with fracture manipulation, with or without skeletal traction; requiring anesthesia
• CPT 23680: Closed treatment of shoulder dislocation, with fracture manipulation, with or without skeletal traction; requiring anesthesia

9. Examples

1. A patient presents with a shoulder joint dislocation. The provider performs closed treatment with manipulation, without the use of anesthesia, to bring the shoulder joint back to its normal alignment.
2. After an X-ray confirms a shoulder joint dislocation, the provider manually adjusts the bones to reduce the dislocation. The procedure is performed without the use of anesthesia.
3. A patient with a shoulder joint dislocation undergoes closed treatment with manipulation. The provider carefully manipulates the bones to bring the shoulder joint back to its normal alignment, without the need for anesthesia.
4. Following an X-ray examination that confirms a shoulder joint dislocation, the provider performs closed treatment with manipulation, without the use of anesthesia, to reduce the dislocation and restore normal alignment.
5. A patient presents with a dislocated shoulder joint. The provider performs closed treatment with manipulation, gently adjusting the bones to bring the shoulder joint back to its normal alignment. Anesthesia is not required for the procedure.
6. After an X-ray confirms a shoulder joint dislocation, the provider performs closed treatment with manipulation, manually adjusting the bones to reduce the dislocation. The procedure is performed without the use of anesthesia.
7. A patient with a shoulder joint dislocation undergoes closed treatment with manipulation. The provider carefully manipulates the bones to bring the shoulder joint back to its normal alignment, without the need for anesthesia.
8. Following an X-ray examination that confirms a shoulder joint dislocation, the provider performs closed treatment with manipulation, without the use of anesthesia, to reduce the dislocation and restore normal alignment.
9. A patient presents with a dislocated shoulder joint. The provider performs closed treatment with manipulation, gently adjusting the bones to bring the shoulder joint back to its normal alignment. Anesthesia is not required for the procedure.
10. After an X-ray confirms a shoulder joint dislocation, the provider performs closed treatment with manipulation, manually adjusting the bones to reduce the dislocation. The procedure is performed without the use of anesthesia.