Overview of CPT Code 23462: Arthroscopic rotator cuff repair

Overview of CPT Code 23462: Arthroscopic rotator cuff repair

CPT Code 23462 refers to the surgical procedure of arthroscopic rotator cuff repair, which is performed to fix tears in the rotator cuff using minimally invasive techniques.

When CPT Code 23462 is Used?

This procedure is indicated in various clinical scenarios.

• Full-thickness rotator cuff tears confirmed by imaging.
• Partial-thickness rotator cuff tears that cause significant pain or dysfunction.
• Rotator cuff tears associated with shoulder instability.
• Persistent shoulder pain and weakness despite conservative treatment.

Symptoms Indicating This Procedure

Patients may report several symptoms that lead to the consideration of this procedure.

• Chronic shoulder pain that worsens with activity.
• Weakness in the shoulder or arm.
• Limited range of motion in the shoulder.
• Pain at night or difficulty sleeping due to shoulder discomfort.

Causes and Risk Factors

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

• Age-related degeneration of the rotator cuff.
• Acute injuries from falls or accidents.
• Repetitive overhead activities, especially in athletes.
• Previous shoulder injuries or surgeries.

Diagnostic Tests Before Procedure

Several diagnostic tests are utilized to confirm the need for surgery.

• MRI to visualize the extent of the rotator cuff tear.
• Ultrasound for real-time imaging of shoulder structures.
• X-rays to rule out other shoulder conditions.
• Physical examination to assess range of motion and strength.

Procedure Description

The procedure involves several key steps to ensure successful repair.

• Patient is placed under general anesthesia.
• Small incisions are made around the shoulder joint.
• An arthroscope is inserted to visualize the tear.
• Damaged tissue is removed, and the tendon is reattached to the bone using sutures or anchors.
• Incisions are closed, and a bandage is applied.

Preparation for the Procedure

Proper preparation is essential for a successful outcome.

• Avoid eating or drinking after midnight before the surgery.
• Discuss current medications with the surgeon, especially blood thinners.
• Arrange for transportation to and from the procedure.
• Wear loose-fitting clothing on the day of surgery.

Recovery and Aftercare

Recovery involves several stages and care practices.

• Initial recovery period lasts about 4 to 6 months.
• Physical therapy is often recommended to regain strength and mobility.
• Keep the surgical area clean and dry to prevent infection.
• Pain management may include prescribed medications or over-the-counter pain relievers.

Possible Complications

While complications are rare, they can occur.

• Infection at the surgical site.
• Persistent pain or stiffness in the shoulder.
• Re-tear of the rotator cuff.
• Nerve damage leading to weakness or numbness.

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Post-Procedure Follow-Up

Follow-up care is crucial for monitoring recovery.

• Initial follow-up within 1 to 2 weeks post-surgery.
• Regular check-ups every 4 to 6 weeks during recovery.
• Assessment of shoulder function and physical therapy progress.

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 medications.

Home Care Tips

Patients can follow these tips for better recovery at home.

• Apply ice packs to reduce swelling.
• Follow prescribed physical therapy exercises.
• Avoid lifting heavy objects or overhead activities.
• Keep follow-up appointments with your healthcare provider.

Patient Education & Prevention

Education on prevention can help avoid future injuries.

• Engage in shoulder-strengthening exercises.
• Use proper techniques during sports and physical activities.
• Avoid repetitive overhead motions when possible.
• Maintain a healthy weight to reduce stress on joints.

Billing and Coding Information

CPT Code: 23462

Category: Surgical Procedures

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 deemed medically necessary.
• Out-of-pocket costs depend on the insurance plan and deductible.

Related CPT Codes

• 23460 - Arthroscopic shoulder debridement