How To Use CPT Code 23665

CPT code 23665 describes the closed treatment of a shoulder joint dislocation with a fracture of the greater humeral tuberosity, along with 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 23665?

CPT 23665 can be used to describe the closed treatment of a shoulder joint dislocation with a fracture of the greater humeral tuberosity, along with manipulation. This code is used when a healthcare provider performs a procedure to realign the dislocated shoulder joint, reduce the fracture in the greater tuberosity of the humerus, and passively move and stretch the shoulder joint.

2. Official Description

The official description of CPT code 23665 is: ‘Closed treatment of shoulder dislocation, with fracture of greater humeral tuberosity, with manipulation.’

3. Procedure

In this procedure, the healthcare provider performs a closed treatment of a shoulder joint dislocation, which is an abnormal separation of a joint. They also reduce a fracture of the greater humeral tuberosity and perform manipulation to passively move and stretch the shoulder joint.

When the patient is appropriately prepped and anesthetized, the provider reduces, or realigns, the shoulder joint dislocation. They first perform an X-ray to examine the dislocated joint. They then manually adjust the bones by pushing or pulling to bring them to their normal alignment. If their manual efforts are unsuccessful, they may suspend a weight from the patient’s arm to move the shoulder back into place. They also reduce the fracture in the greater tuberosity of the humerus. Finally, they place the shoulder joint in a sling or brace for a period of four weeks to help with healing. They may perform an X-ray examination of the joint to confirm the reduction of the dislocation and tubercle fracture.

4. Qualifying circumstances

Patients eligible to receive CPT 23665 services are those with a shoulder joint dislocation and a fracture of the greater humeral tuberosity. The healthcare provider must perform closed treatment of the dislocation and manipulate the shoulder joint to qualify for this code.

5. When to use CPT code 23665

CPT code 23665 should be used when a healthcare provider performs a closed treatment of a shoulder joint dislocation with a fracture of the greater humeral tuberosity, along with manipulation. This code should not be used for other types of shoulder dislocations or fractures.

6. Documentation requirements

To support a claim for CPT 23665, the healthcare provider must document the following information:

• Patient’s diagnosis of shoulder joint dislocation and fracture of the greater humeral tuberosity
• Description of the closed treatment procedure performed, including manipulation of the shoulder joint
• Date of the procedure
• Start and end time of the procedure
• Details of any X-ray examinations performed
• Placement of the shoulder joint in a sling or brace
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 23665, ensure that the healthcare provider performs the closed treatment of the shoulder joint dislocation with a fracture of the greater humeral tuberosity, along with manipulation. This code should not be reported with other codes unless there are specific circumstances that warrant additional codes. It is important to follow the specific guidelines provided by the payer when submitting claims for CPT 23665.

8. Historical information

CPT 23665 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 23665

Five similar codes to CPT 23665 include:

• CPT 23675: Closed treatment of shoulder dislocation, with surgical or anatomical neck fracture, with manipulation
• CPT 23660: Closed treatment of shoulder dislocation, with fracture of surgical neck of humerus, with manipulation
• CPT 23670: Closed treatment of shoulder dislocation, with fracture of greater humeral tuberosity, without manipulation
• CPT 23680: Closed treatment of shoulder dislocation, with fracture of surgical neck of humerus, without manipulation
• CPT 23666: Closed treatment of shoulder dislocation, with fracture of lesser humeral tuberosity, with manipulation

9. Examples

1. A healthcare provider performs a closed treatment of a shoulder joint dislocation with a fracture of the greater humeral tuberosity, along with manipulation.
2. A patient presents with a shoulder joint dislocation and a fracture of the greater humeral tuberosity. The healthcare provider performs a closed treatment procedure to realign the joint and reduce the fracture.
3. During a sports activity, a patient sustains a shoulder joint dislocation and a fracture of the greater humeral tuberosity. The healthcare provider performs a closed treatment procedure to manipulate the joint and reduce the fracture.
4. A healthcare provider performs a closed treatment of a shoulder joint dislocation with a fracture of the greater humeral tuberosity, along with manipulation, on a patient involved in a car accident.
5. A patient with a shoulder joint dislocation and a fracture of the greater humeral tuberosity undergoes a closed treatment procedure performed by a healthcare provider to realign the joint and reduce the fracture.
6. Following a fall, a patient presents with a shoulder joint dislocation and a fracture of the greater humeral tuberosity. The healthcare provider performs a closed treatment procedure to manipulate the joint and reduce the fracture.
7. A healthcare provider performs a closed treatment of a shoulder joint dislocation with a fracture of the greater humeral tuberosity, along with manipulation, on an elderly patient.
8. A patient involved in a sports-related injury presents with a shoulder joint dislocation and a fracture of the greater humeral tuberosity. The healthcare provider performs a closed treatment procedure to realign the joint and reduce the fracture.
9. During a physical altercation, a patient sustains a shoulder joint dislocation and a fracture of the greater humeral tuberosity. The healthcare provider performs a closed treatment procedure to manipulate the joint and reduce the fracture.