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Arthrodesis of the shoulder, specifically the glenohumeral joint, is a surgical procedure aimed at fusing the joint to alleviate pain and restore function. This procedure is particularly relevant for patients suffering from severe joint conditions, such as arthritis or instability, where conservative treatments have failed. The surgery involves a deltopectoral approach, which is a surgical technique that allows access to the shoulder joint by making an incision along the deltopectoral interval. This approach facilitates the identification and retraction of the cephalic vein and the conjoint tendon, which are critical structures in the shoulder region. The procedure requires careful dissection and manipulation of the subscapularis tendon and the joint capsule to gain access to the glenohumeral joint. Once the joint is exposed, it is dislocated to allow for the removal of cortical bone from the joint surfaces, including the acromion, glenoid fossa, and humeral head. This preparation is essential for achieving a successful fusion. If an autograft is indicated, bone is harvested either locally or from a remote site, such as the iliac crest, to facilitate the fusion process. The graft is then placed into the joint space, and the humerus is repositioned into the joint socket. The procedure also involves specific positioning of the humerus to ensure proper contact with the acromion, followed by the application of fixation devices to stabilize the joint during the healing process. The use of a shoulder spica cast post-surgery is crucial for immobilization, promoting optimal recovery and fusion of the joint.
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The procedure of arthrodesis of the glenohumeral joint is indicated for several specific conditions and symptoms, which include:
The arthrodesis procedure involves several critical steps to ensure successful fusion of the glenohumeral joint:
After the arthrodesis procedure, patients are typically required to follow specific post-operative care guidelines to ensure proper recovery. The shoulder will be immobilized in a shoulder spica cast, which is essential for maintaining the position of the joint and promoting the fusion process. Patients may experience pain and swelling, which can be managed with prescribed medications. Physical therapy may be initiated after a period of immobilization, focusing on gentle range-of-motion exercises to gradually restore function while protecting the surgical site. Regular follow-up appointments are necessary to monitor the healing process and assess the success of the fusion. Patients should be advised on activity restrictions to avoid undue stress on the joint during the recovery phase.
| Short Descr | ARTHRODESIS GLENOHUMERAL JT | Medium Descr | ARTHRODESIS GLENOHUMERAL JOINT | Long Descr | Arthrodesis, glenohumeral joint; | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 162 - Other OR therapeutic procedures on joints |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) |
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| 2023-01-01 | Note | Short description changed. |
| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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