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The CPT® Code 23900 refers to an interthoracoscapular amputation, commonly known as a forequarter amputation. This surgical procedure involves the complete removal of the shoulder blade (scapula), collarbone (clavicle), and the entire arm, including associated soft tissues of the shoulder region. The primary purpose of this amputation is to address severe conditions resulting from disease or injury that compromise the integrity and function of the upper limb. Such conditions may include extensive malignancies, traumatic injuries, or severe infections that cannot be managed through less invasive means. The procedure is significant due to its extensive nature, as it not only removes the limb but also involves the excision of critical anatomical structures that play a vital role in upper body mobility and function. Understanding the implications of this procedure is essential for medical coders and healthcare professionals involved in the documentation and billing processes, as it requires precise coding to ensure appropriate reimbursement and compliance with healthcare regulations.
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The interthoracoscapular amputation (forequarter) is indicated in specific clinical scenarios where the removal of the shoulder blade, collarbone, and arm is necessary due to severe underlying conditions. These indications may include:
The procedure for interthoracoscapular amputation involves several critical steps to ensure the safe and effective removal of the affected anatomical structures. These steps include:
Post-procedure care following an interthoracoscapular amputation is critical for patient recovery and includes monitoring for complications such as infection, bleeding, or issues related to wound healing. Patients may require pain management and rehabilitation services to adapt to the loss of the limb and to learn new methods of mobility and daily activities. Follow-up appointments are essential to assess the surgical site and to provide any necessary prosthetic fittings or adjustments. The overall recovery process may vary based on the individual’s health status and the extent of the surgery performed.
| Short Descr | INTERTHORACOSCPLR AMPUTATION | Medium Descr | INTERTHORACOSCAPULAR AMPUTATION | Long Descr | Interthoracoscapular amputation (forequarter) | 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) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | 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) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 164 - Other OR therapeutic procedures on musculoskeletal system |
| 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. | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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.) | 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). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 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. |
| Pre-1990 | Added | Code added. |
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