Overview of CPT Code 23470: Arthroscopic rotator cuff repair

Overview of CPT Code 23470: Arthroscopic rotator cuff repair

CPT Code 23470 refers to the surgical procedure known as arthroscopic rotator cuff repair, which is performed to fix tears in the rotator cuff using minimally invasive techniques.

When CPT Code 23470 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.
• Persistent shoulder pain and weakness despite conservative treatment.
• Acute rotator cuff injuries following trauma.

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 and management.

• Age-related degeneration of the rotator cuff.
• Repetitive overhead activities, such as in athletes or manual laborers.
• Previous shoulder injuries or surgeries.
• Genetic predisposition to tendon injuries.

Diagnostic Tests Before Procedure

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

• MRI or ultrasound 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.
• An arthroscope is inserted to visualize the joint.
• Torn tendon edges are identified and prepared.
• Sutures are used to reattach the tendon to the bone.
• Incisions are closed with sutures or adhesive.

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 post-surgery.
• Wear loose-fitting clothing for the day of the procedure.

Recovery and Aftercare

Recovery involves several important steps.

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

Possible Complications

While complications are rare, they can occur.

• Infection at the surgical site.
• Persistent pain or stiffness.
• Re-tear of the rotator cuff.
• Nerve or blood vessel injury.

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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 visits every 4 to 6 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.
• 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 a healthy weight to reduce joint stress.
• Seek early treatment for shoulder pain.

Billing and Coding Information

CPT Code: 23470

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.

Related CPT Codes

• 23466 - Arthroscopic rotator cuff repair
• 23462 - Arthroscopic rotator cuff repair