Overview of CPT Code 23450:Repair of Complete Rotator Cuff Tear
CPT Code 23450 refers to the surgical repair of a complete tear of the rotator cuff, a group of muscles and tendons that stabilize the shoulder joint. This procedure is typically performed when conservative treatments have failed to alleviate symptoms.
When CPT Code 23450 is Used?
This procedure is indicated in various clinical scenarios.
- Complete rotator cuff tear confirmed by imaging studies.
- Persistent shoulder pain and weakness affecting daily activities.
- Failure of conservative treatments such as physical therapy and corticosteroid injections.
Symptoms Indicating This Procedure
Patients may report several symptoms that suggest the need for surgical intervention.
- Severe shoulder pain, especially at night.
- Weakness in the shoulder or arm.
- Limited range of motion in the shoulder.
- Difficulty performing overhead activities.
Causes and Risk Factors
Understanding the causes and risk factors can help in prevention and management.
- Age-related degeneration of the rotator cuff.
- Acute injuries from falls or accidents.
- Repetitive overhead activities, especially in sports or certain occupations.
- Previous shoulder injuries or surgeries.
Diagnostic Tests Before Procedure
Several diagnostic tests are utilized to confirm the diagnosis.
- MRI of the shoulder to visualize the rotator cuff.
- Ultrasound imaging to assess the integrity of the rotator cuff.
- X-rays to rule out other shoulder conditions.
Procedure Description
The surgical procedure involves several key steps.
- Anesthesia is administered to ensure patient comfort.
- An incision is made over the shoulder to access the rotator cuff.
- The torn edges of the rotator cuff are identified and prepared.
- The torn tendon is reattached to the humerus using sutures or anchors.
- The incision is closed with sutures or staples.
Preparation for the Procedure
Proper preparation is essential for a successful surgery.
- Avoid eating or drinking after midnight before the surgery.
- Discuss any medications with your doctor, especially blood thinners.
- Arrange for transportation to and from the surgical facility.
- Wear loose-fitting clothing on the day of the procedure.
Recovery and Aftercare
Post-operative care is crucial for optimal recovery.
- Initial recovery may take 4 to 6 months.
- Physical therapy is often recommended to regain strength and mobility.
- Keep the surgical site clean and dry; follow wound care instructions.
- Pain management may include prescribed medications.
Possible Complications
As with any surgical procedure, there are potential risks.
- Infection at the surgical site.
- Re-tear of the rotator cuff.
- Stiffness or limited range of motion.
- Nerve injury leading to weakness or numbness.
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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 typically start 4 to 6 weeks after surgery.
Alternative Treatments
Non-surgical options may be considered before surgery.
- Physical therapy to strengthen shoulder muscles.
- Corticosteroid injections to reduce inflammation.
- Activity modification to avoid aggravating the injury.
- Pain management with over-the-counter medications.
Home Care Tips
Patients can take steps at home to aid recovery.
- Follow the prescribed physical therapy regimen.
- Apply ice to the shoulder to reduce swelling.
- Avoid lifting heavy objects or overhead activities.
- Use a sling as directed to support the shoulder.
Patient Education & Prevention
Education on prevention can help reduce recurrence.
- Engage in shoulder-strengthening exercises.
- Avoid repetitive overhead motions when possible.
- Maintain a healthy weight to reduce stress on joints.
- Seek early treatment for shoulder pain to prevent worsening.
Billing and Coding Information
CPT Code: 23450
Category: Surgery
Common Modifiers:
- 50 - Bilateral procedure
- RT - Right side
- LT - Left side
Average Cost and Insurance Coverage
Costs can vary based on several factors.
- Average cost ranges from $10,000 to $20,000.
- Insurance typically covers the procedure if medically necessary.
- Out-of-pocket costs depend on the insurance plan and deductible.
Related CPT Codes
Frequently Asked Questions (FAQs)
What is a rotator cuff tear?
A rotator cuff tear is a rupture of the tendons that stabilize the shoulder.
How long is the recovery time?
Recovery can take 4 to 6 months, depending on the severity of the tear.
Will I need physical therapy?
Yes, physical therapy is often necessary to regain strength and mobility.
What are the risks of surgery?
Risks include infection, re-tear, and stiffness in the shoulder.
