Overview of CPT Code 23105: Excision of soft tissue tumor, shoulder
CPT Code 23105 refers to the surgical excision of a soft tissue tumor located in the shoulder region. This procedure is performed to remove tumors that may be benign or malignant, ensuring that any potentially harmful tissue is eliminated.
When CPT Code 23105 is Used?
This procedure is indicated in various clinical scenarios.
- Presence of a palpable soft tissue tumor in the shoulder area.
- Tumors that are symptomatic, causing pain or discomfort.
- Suspicion of malignancy based on imaging or physical examination.
- Tumors that are growing or changing in appearance.
Symptoms Indicating This Procedure
Patients may report several symptoms that lead to the consideration of this procedure.
- A noticeable lump or mass in the shoulder region.
- Pain or tenderness in the shoulder area.
- Limited range of motion due to the tumor.
- Changes in the skin over the tumor, such as redness or ulceration.
Causes and Risk Factors
Understanding the causes and risk factors can help in identifying patients who may need this procedure.
- Genetic predisposition to certain types of tumors.
- Previous history of tumors or cancers.
- Age, as certain tumors are more common in specific age groups.
- Occupational exposure to carcinogens.
Diagnostic Tests Before Procedure
Several diagnostic tests may be performed to evaluate the tumor before excision.
- Ultrasound imaging to assess the size and characteristics of the tumor.
- MRI to evaluate the extent of the tumor and its relation to surrounding structures.
- Biopsy to determine the nature of the tumor (benign or malignant).
- X-rays to rule out any underlying bone involvement.
Procedure Description
The excision procedure involves several key steps.
- Patient is positioned comfortably, and the shoulder area is cleaned and sterilized.
- Local anesthesia is administered to numb the area.
- An incision is made over the tumor to access the soft tissue.
- The tumor is carefully excised along with a margin of healthy tissue.
- The incision is closed with sutures or staples, and a sterile dressing is applied.
Preparation for the Procedure
Proper preparation is essential for a successful procedure.
- Avoid eating or drinking for at least 8 hours before the procedure if sedation is planned.
- Discuss any medications with your doctor, especially blood thinners.
- Arrange for transportation to and from the procedure.
- Wear loose-fitting clothing to allow easy access to the shoulder.
Recovery and Aftercare
Post-operative care is crucial for healing.
- Rest the shoulder and avoid strenuous activities for at least a week.
- Keep the incision site clean and dry, changing dressings as instructed.
- Take prescribed pain medications as needed.
- Attend follow-up appointments to monitor healing and remove sutures if necessary.
Possible Complications
While complications are rare, they can occur.
- Infection at the incision site.
- Excessive bleeding during or after the procedure.
- Scarring or changes in skin sensation.
- Recurrence of the tumor if not completely excised.
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Post-Procedure Follow-Up
Follow-up care is important for monitoring recovery.
- Schedule a follow-up visit within 1-2 weeks post-surgery.
- Monitor for signs of infection or complications.
- Discuss pathology results if a biopsy was performed.
- Plan for any additional treatments if the tumor is malignant.
Alternative Treatments
In some cases, non-surgical options may be considered.
- Observation for benign tumors that are not causing symptoms.
- Corticosteroid injections to reduce inflammation.
- Physical therapy to improve shoulder function without surgery.
- Radiation therapy for certain malignant tumors.
Home Care Tips
Patients can take steps at home to aid recovery.
- Apply ice packs to the shoulder to reduce swelling.
- Follow a balanced diet to support healing.
- Avoid lifting heavy objects until cleared by your doctor.
- Keep the surgical area clean and dry.
Patient Education & Prevention
Educating patients can help prevent recurrence.
- Regular self-examinations of the shoulder for new lumps.
- Awareness of family history of tumors.
- Healthy lifestyle choices to reduce cancer risk.
- Promptly report any changes in the shoulder area to a healthcare provider.
Billing and Coding Information
CPT Code: 23105
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 $2,000 to $5,000 depending on facility and complexity.
- 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 a soft tissue tumor?
A soft tissue tumor is a growth that develops in the soft tissues of the body, such as muscles, fat, and connective tissues.
Is the excision procedure painful?
Local anesthesia is used during the procedure, so you should not feel pain. Some discomfort may occur afterward.
How long does recovery take?
Most patients can return to normal activities within 1-2 weeks, depending on the extent of the surgery.
Will there be a scar after the procedure?
There may be a scar, but it typically fades over time. Your surgeon will take steps to minimize scarring.
What should I do if I notice signs of infection?
Contact your healthcare provider immediately if you notice increased redness, swelling, or discharge from the incision site.
