Overview of CPT Code 23466: Arthroscopic rotator cuff repair

Overview of CPT Code 23466: Arthroscopic rotator cuff repair

CPT Code 23466 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 23466 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 suggest the need for this procedure.

• 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.

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

Diagnostic Tests Before Procedure

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

• MRI or ultrasound imaging to visualize the rotator cuff.
• 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.

• 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 medications with your doctor, especially blood thinners.
• Arrange for transportation home after the procedure.
• Wear loose-fitting clothing for the day of surgery.

Recovery and Aftercare

Recovery involves several important steps.

• Initial recovery period of 4 to 6 months for full healing.
• Physical therapy to regain strength and mobility.
• Pain management with prescribed medications.
• Wound care to keep the surgical site clean and dry.

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 appointment within 1 to 2 weeks post-surgery.
• Regular check-ups every few weeks during recovery.
• Assessment of shoulder function and pain levels.

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 follow these tips for better recovery.

• Keep the surgical area clean and dry.
• Follow prescribed physical therapy exercises.
• Use ice packs to reduce swelling and pain.
• Avoid lifting heavy objects during recovery.

Patient Education & Prevention

Education is key to preventing future injuries.

• Engage in shoulder-strengthening exercises.
• Avoid repetitive overhead activities without breaks.
• Maintain good posture to reduce shoulder strain.
• Seek early treatment for shoulder pain to prevent worsening.

Billing and Coding Information

CPT Code: 23466

Category: Surgical Procedures

Common Modifiers:

• -50
• -RT
• -LT

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.

Related CPT Codes

• 23465 - Arthroscopic rotator cuff repair
• 23470 - Arthroscopic rotator cuff repair
• 23462 - Arthroscopic rotator cuff repair