Overview of CPT Code 23020: Excision of shoulder bursa
CPT Code 23020 refers to the surgical procedure for the excision of the shoulder bursa, a fluid-filled sac that reduces friction between tissues in the shoulder joint. This procedure is typically performed to alleviate pain and improve mobility in patients suffering from bursitis or other shoulder conditions.
When CPT Code 23020 is Used?
This procedure is indicated in several clinical scenarios.
- Chronic shoulder pain due to bursitis that has not responded to conservative treatments.
- Recurrent shoulder inflammation or swelling.
- Limited range of motion in the shoulder joint.
- Presence of calcific deposits in the bursa causing pain.
Symptoms Indicating This Procedure
Patients may report various symptoms that lead to the consideration of this procedure.
- Persistent shoulder pain, especially during movement.
- Swelling or tenderness around the shoulder joint.
- Stiffness or reduced range of motion in the shoulder.
- Pain that worsens at night or with specific activities.
Causes and Risk Factors
Understanding the underlying causes and risk factors is crucial for prevention.
- Repetitive overhead activities or sports.
- Age-related degeneration of shoulder structures.
- Previous shoulder injuries or trauma.
- Certain medical conditions like rheumatoid arthritis.
Diagnostic Tests Before Procedure
Several diagnostic tests may be performed to confirm the need for this procedure.
- X-rays to rule out fractures or bone spurs.
- MRI to assess soft tissue structures and inflammation.
- Ultrasound to visualize the bursa and surrounding tissues.
- Physical examination to evaluate range of motion and pain.
Procedure Description
The excision of the shoulder bursa involves several key steps.
- Administer anesthesia to ensure patient comfort.
- Make an incision over the affected area of the shoulder.
- Carefully dissect the tissue to expose the bursa.
- Remove the inflamed bursa and any surrounding tissue as necessary.
- Close the incision with sutures or staples.
Preparation for the Procedure
Proper preparation is essential for a successful outcome.
- Discuss any medications with your doctor, especially blood thinners.
- Avoid eating or drinking for a specified period before surgery.
- Arrange for transportation to and from the procedure.
- Wear loose-fitting clothing on the day of the surgery.
Recovery and Aftercare
Post-operative care is vital for healing.
- Rest the shoulder and avoid strenuous activities for several weeks.
- Follow up with your doctor for suture removal if necessary.
- Apply ice to reduce swelling and manage pain.
- Take prescribed pain medications as directed.
Possible Complications
As with any surgical procedure, there are potential risks.
- Infection at the surgical site.
- Persistent pain or stiffness in the shoulder.
- Nerve damage leading to weakness or numbness.
- Recurrence of bursitis.
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Post-Procedure Follow-Up
Regular follow-up is important for monitoring recovery.
- Initial follow-up appointment within 1-2 weeks post-surgery.
- Additional visits as needed to assess healing and function.
- Physical therapy may be recommended to restore strength and mobility.
Alternative Treatments
There are non-surgical options available for managing shoulder issues.
- Physical therapy to strengthen shoulder muscles.
- Corticosteroid injections to reduce inflammation.
- Non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief.
- Activity modification to avoid aggravating the condition.
Home Care Tips
Patients can take steps at home to aid recovery.
- Keep the surgical area clean and dry.
- Use ice packs to manage swelling.
- Follow a gentle range of motion exercises as advised.
- Avoid heavy lifting or overhead activities until cleared by your doctor.
Patient Education & Prevention
Educating patients on prevention can help avoid recurrence.
- Engage in shoulder-strengthening exercises.
- Avoid repetitive overhead motions when possible.
- Maintain a healthy weight to reduce joint stress.
- Seek early treatment for shoulder pain to prevent worsening.
Billing and Coding Information
CPT Code: 23020
Category: Surgery
Common Modifiers:
- 50 - Bilateral procedure
- 59 - Distinct procedural service
Average Cost and Insurance Coverage
Costs can vary based on several factors.
- Average cost ranges from $3,000 to $7,000 depending on facility and location.
- Most insurance plans cover the procedure if deemed medically necessary.
- Out-of-pocket costs may vary based on deductible and co-insurance.
Related CPT Codes
Frequently Asked Questions (FAQs)
What is the purpose of the excision of the shoulder bursa?
The procedure aims to relieve pain and improve shoulder function by removing the inflamed bursa.
How long does the recovery take?
Recovery typically takes several weeks, with gradual return to normal activities.
Will I need physical therapy after the procedure?
Yes, physical therapy is often recommended to restore strength and mobility.
Are there any risks associated with this surgery?
As with any surgery, there are risks such as infection, nerve damage, and recurrence of symptoms.
