Overview of CPT Code 23472: Arthroscopic rotator cuff repair

Overview of CPT Code 23472: Arthroscopic rotator cuff repair

CPT Code 23472 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 23472 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.

• 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 early intervention.

• 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 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 to ensure successful repair.

• Anesthesia is administered to ensure patient comfort.
• Small incisions are made around the shoulder joint.
• An arthroscope is inserted to visualize the tear.
• Instruments are used to repair the torn rotator cuff.
• The 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 to and from the procedure.
• Wear loose-fitting clothing on the day of surgery.

Recovery and Aftercare

Recovery involves several important steps to ensure healing.

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

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 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 take several steps at home to aid recovery.

• Follow the prescribed physical therapy regimen.
• Apply ice to the shoulder to reduce swelling.
• Keep the surgical area clean and dry.
• Avoid lifting heavy objects until cleared by the doctor.

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: 23472

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

• 23470 - Arthroscopic rotator cuff repair
• 23460 - Arthroscopic shoulder debridement