Overview of CPT Code 23491: Arthroscopic rotator cuff repair
CPT Code 23491 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 23491 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 is performed using minimally invasive techniques.
- 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 stages and proper aftercare.
- Initial recovery period lasts about 4 to 6 months.
- Physical therapy is often recommended to regain strength.
- 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.
- 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 check-ups 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
Simple tips can aid in recovery at home.
- Follow your surgeon's instructions carefully.
- Use ice packs to reduce swelling.
- Keep the arm elevated to minimize discomfort.
- Engage in prescribed exercises to promote healing.
Patient Education & Prevention
Education is key to preventing future injuries.
- Maintain shoulder strength through regular exercise.
- Avoid repetitive overhead activities without breaks.
- Use proper techniques during sports and physical activities.
- Consult a healthcare provider for persistent shoulder issues.
Billing and Coding Information
CPT Code: 23491
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 medically necessary.
- Out-of-pocket costs depend on the insurance plan.
Related CPT Codes
Frequently Asked Questions (FAQs)
What is the recovery time for this procedure?
Recovery typically takes 4 to 6 months.
Will I need physical therapy after surgery?
Yes, physical therapy is often recommended.
Are there risks associated with this surgery?
Like any surgery, there are risks such as infection or re-tear.
How long will I be in the hospital?
Most patients go home the same day as the surgery.
