How To Use CPT Code 23800

CPT 23800 describes the surgical procedure known as arthrodesis of the glenohumeral joint. 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 23800?

CPT 23800 is used to describe the surgical procedure of arthrodesis of the glenohumeral joint. This procedure involves surgically immobilizing the shoulder joint using fixation devices. It is typically performed to restore function to the shoulder in cases of arthritis or a failed shoulder replacement.

2. Official Description

The official description of CPT code 23800 is: ‘Arthrodesis, glenohumeral joint.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider makes an incision in the skin of the shoulder, extending from the acromion process to the shaft of the humerus.
3. The provider dissects through the subcutaneous tissue and retracts the muscles, blood vessels, and nerves to expose the glenohumeral joint.
4. The rotator cuff muscles are resected.
5. The provider cuts the joint capsule to enter the joint.
6. The glenohumeral joint cartilage is thoroughly debrided using a surgical burr.
7. The provider fuses the glenohumeral joint using fixation devices such as K wires, powered staples, plates, or headless screws.
8. All bleeding at the surgical site is stopped, and the wound is closed by suturing the soft tissue in layers.
9. The shoulder joint is placed in a sling or brace for four to six weeks to aid in healing.

4. Qualifying circumstances

CPT 23800 is performed on patients with conditions such as arthritis or failed shoulder replacement, where surgical immobilization of the glenohumeral joint is necessary to restore function. The procedure is typically performed by a qualified healthcare professional, such as an orthopedic surgeon, with the use of fixation devices to restrict movement and alleviate pain.

5. When to use CPT code 23800

CPT code 23800 should be used when a provider performs arthrodesis of the glenohumeral joint using fixation devices. It is important to ensure that the procedure is medically necessary and meets the criteria for surgical immobilization of the shoulder joint.

6. Documentation requirements

To support a claim for CPT 23800, the provider must document the following information:

• Patient’s diagnosis and the need for arthrodesis of the glenohumeral joint
• Details of the surgical procedure, including the specific fixation devices used
• Date of the procedure
• Any additional procedures performed during the same surgical session
• Post-operative care instructions
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 23800, ensure that the procedure meets the criteria for arthrodesis of the glenohumeral joint. It is important to follow the specific guidelines provided by the payer and use the appropriate modifiers, if required. It is also important to consider any bundling or unbundling rules that may apply to the procedure.

8. Historical information

CPT 23800 was added to the Current Procedural Terminology system on January 1, 1990. The code was later changed on January 1, 2010, with the description remaining the same.

9. Examples

1. An orthopedic surgeon performing arthrodesis of the glenohumeral joint using K wires to immobilize the joint in a patient with severe arthritis.
2. A provider performing arthrodesis of the glenohumeral joint with a prosthetic replacement in a patient with a failed shoulder replacement.
3. An orthopedic surgeon performing arthrodesis of the glenohumeral joint with an autogenous graft in a patient with a history of shoulder instability.
4. A provider performing arthrodesis of the glenohumeral joint with an allograft in a patient with a failed previous fusion.
5. An orthopedic surgeon performing arthrodesis of the glenohumeral joint with coracoid process transfer (Eden-Hybinette procedure) in a patient with recurrent shoulder dislocations.