Overview of CPT Code 23065: Repair of shoulder joint capsule

Overview of CPT Code 23065: Repair of shoulder joint capsule

CPT Code 23065 refers to the surgical repair of the shoulder joint capsule, which is essential for stabilizing the shoulder and restoring its function. This procedure is often performed when there is significant damage to the joint capsule due to injury or chronic conditions.

When CPT Code 23065 is Used?

This procedure is indicated in various clinical scenarios.

• Severe shoulder instability due to a tear in the joint capsule.
• Recurrent shoulder dislocations that do not respond to conservative treatment.
• Post-traumatic shoulder capsule injuries.
• Chronic shoulder pain associated with joint capsule damage.

Symptoms Indicating This Procedure

Patients may report several symptoms that suggest the need for this procedure.

• Persistent shoulder pain, especially during movement.
• Frequent shoulder dislocations or feelings of instability.
• Swelling and tenderness around the shoulder joint.
• Limited range of motion in the shoulder.

Causes and Risk Factors

Understanding the causes and risk factors can help in prevention and early intervention.

• Traumatic injuries such as falls or sports-related accidents.
• Chronic overuse injuries from repetitive shoulder activities.
• Previous shoulder surgeries that may weaken the joint capsule.
• Genetic predisposition to joint laxity.

Diagnostic Tests Before Procedure

Several diagnostic tests may be performed to assess the condition of the shoulder joint.

• X-rays to evaluate bone structure and joint alignment.
• MRI scans to visualize soft tissue damage, including the joint capsule.
• Ultrasound to assess the shoulder's dynamic function.
• Physical examination to assess range of motion and stability.

Procedure Description

The procedure involves several key steps to ensure effective repair.

• Administer anesthesia to ensure patient comfort.
• Make an incision around the shoulder joint to access the capsule.
• Identify and assess the extent of the damage to the joint capsule.
• Suture the torn edges of the capsule together to restore stability.
• Close the incision with sutures or staples and apply a sterile dressing.

Preparation for the Procedure

Proper preparation is crucial for a successful outcome.

• Consult with the surgeon to discuss the procedure and any concerns.
• Avoid eating or drinking for a specified period before surgery.
• Arrange for transportation to and from the surgical facility.
• Follow any specific pre-operative instructions provided by the healthcare team.

Recovery and Aftercare

Post-operative care is essential for optimal recovery.

• Expected recovery period is typically 4 to 6 months.
• Keep the surgical area clean and dry; follow wound care instructions.
• Use prescribed pain medications as directed.
• Engage in physical therapy as recommended to regain strength and mobility.

Possible Complications

While complications are rare, they can occur.

• Infection at the surgical site.
• Nerve damage leading to weakness or numbness.
• Persistent pain or stiffness in the shoulder.
• Recurrent instability or dislocation of the shoulder.

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Post-Procedure Follow-Up

Regular follow-up is important to monitor recovery.

• Initial follow-up appointment within 1 to 2 weeks post-surgery.
• Subsequent visits every 4 to 6 weeks to assess healing.
• Physical therapy sessions as prescribed to aid recovery.
• Long-term follow-up to monitor shoulder function and stability.

Alternative Treatments

Non-surgical options may be considered before surgery.

• Physical therapy to strengthen shoulder muscles and improve stability.
• Corticosteroid injections to reduce inflammation and pain.
• Activity modification to avoid aggravating the shoulder.
• Use of a shoulder brace to provide support during healing.

Home Care Tips

Patients can take several steps to aid their recovery at home.

• Follow all post-operative care instructions provided by your surgeon.
• Keep the shoulder immobilized as directed to promote healing.
• Apply ice packs to reduce swelling and discomfort.
• Gradually resume activities as advised by your healthcare provider.

Patient Education & Prevention

Education is key to preventing future issues.

• Engage in shoulder-strengthening exercises to maintain stability.
• Avoid high-risk activities that may lead to shoulder injuries.
• Seek prompt treatment for any shoulder pain or instability.
• Educate yourself on proper techniques for sports and physical activities.

Billing and Coding Information

CPT Code: 23065

Category: Surgery

Common Modifiers:

• -50
• -RT
• -LT

Average Cost and Insurance Coverage

Costs can vary based on several factors.

• Average cost ranges from $5,000 to $15,000 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

• 23410 - Repair of Rotator Cuff
• 23412 - Arthroscopic repair of shoulder labrum
• 23420 - Arthroscopic Shoulder Surgery for Rotator Cuff Repair
• 23430 - Arthroscopy, shoulder, surgical; with rotator cuff repair