How To Use CPT Code 23921

CPT code 23921 describes the disarticulation of the shoulder with secondary closure or scar revision. 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 23921?

CPT 23921 is a code used to describe the disarticulation of the shoulder with secondary closure or scar revision. This procedure is performed by a healthcare provider to remodel the skin and muscle structures of a stump left after the amputation of the upper extremity through the shoulder. It is typically done when there has been an improper initial closure or when there is pain due to contracture in the wound.

2. Official Description

The official description of CPT code 23921 is: ‘Disarticulation of shoulder secondary closure or scar revision.’

3. Procedure

During the procedure, the healthcare provider first preps and anesthetizes the patient. They then excise any dead skin and granulation tissue from around the stump that remains after the amputation of the upper extremity through the shoulder joint. After irrigating the wound with antibiotics, the provider creates skin and muscle flaps, which are pulled over the stump and sutured to cover the wound.

4. Qualifying circumstances

CPT 23921 is performed when there has been an improper initial closure or when there is pain due to contracture in the wound. It is important to note that this procedure is specific to the disarticulation of the shoulder and should not be used for other types of amputations or closures.

5. When to use CPT code 23921

CPT code 23921 should be used when a healthcare provider performs the disarticulation of the shoulder with secondary closure or scar revision. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 23921, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for disarticulation of the shoulder with secondary closure or scar revision
• Details of the procedure performed, including any excision of dead skin and granulation tissue
• Date of the procedure
• Start and end time of the procedure
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 23921, ensure that the procedure meets the specific criteria outlined in the code description. It is important to follow the appropriate coding guidelines and modifiers, if applicable. Additionally, be aware of any bundling or unbundling issues that may affect the billing of this code.

8. Historical information

CPT 23921 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 23921

There are several similar codes to CPT 23921 that describe different procedures related to amputations and closures. These include:

• CPT 23900: Disarticulation of shoulder joint
• CPT 23920: Disarticulation of shoulder with immediate closure
• CPT 23929: Unlisted procedure, shoulder
• CPT 23930: Disarticulation of shoulder with prosthetic replacement
• CPT 23931: Disarticulation of shoulder with prosthetic replacement and secondary closure or scar revision

9. Examples

1. A patient undergoes disarticulation of the shoulder with secondary closure due to an improper initial closure that resulted in wound complications.
2. A healthcare provider performs scar revision on a patient who experienced pain and contracture in the wound following the disarticulation of the shoulder.
3. A patient undergoes disarticulation of the shoulder with secondary closure to improve the appearance of the scar and enhance functional outcomes.
4. A healthcare provider performs scar revision on a patient who developed excessive scar tissue after the disarticulation of the shoulder.
5. A patient undergoes disarticulation of the shoulder with secondary closure to address wound healing issues and prevent further complications.
6. A healthcare provider performs scar revision on a patient who experienced discomfort and limited range of motion in the shoulder due to scar contracture.
7. A patient undergoes disarticulation of the shoulder with secondary closure to address infection and promote proper wound healing.
8. A healthcare provider performs scar revision on a patient who developed keloid formation following the disarticulation of the shoulder.
9. A patient undergoes disarticulation of the shoulder with secondary closure to improve the fit and function of a prosthetic limb.
10. A healthcare provider performs scar revision on a patient who experienced persistent pain and irritation at the site of the disarticulation of the shoulder.