Overview of CPT Code 23474: Arthroscopic rotator cuff repair
CPT Code 23474 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 23474 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.
- 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 torn tendon is reattached to the bone using anchors.
- The incisions are closed, and the shoulder is bandaged.
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 home post-surgery.
- Wear loose-fitting clothing for the day of the procedure.
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.
- Pain management may include 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 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 4 to 6 weeks during recovery.
- Assessment of shoulder function and physical therapy progress.
Alternative Treatments
There are non-surgical options available for managing rotator cuff issues.
- 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.
- Apply ice packs to reduce swelling.
- Follow prescribed physical therapy exercises.
- Avoid lifting heavy objects or overhead activities.
- Keep follow-up appointments to monitor healing.
Patient Education & Prevention
Education on prevention can help reduce the risk of 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: 23474
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 deemed medically necessary.
- Out-of-pocket costs depend on the insurance plan and deductible.
Related CPT Codes
Frequently Asked Questions (FAQs)
What is an arthroscopic rotator cuff repair?
It is a minimally invasive surgery to repair tears in the rotator cuff.
How long does recovery take?
Recovery typically takes 4 to 6 months, depending on individual healing.
Will I need physical therapy after surgery?
Yes, physical therapy is usually recommended to regain strength and mobility.
Are there risks associated with this procedure?
As with any surgery, there are risks such as infection and re-tear.
