Overview of CPT Code 23545: Open treatment of humeral fracture

CPT Code 23545 refers to the open treatment of a humeral fracture, which involves surgical intervention to realign and stabilize a broken humerus bone in the upper arm.

When CPT Code 23545 is Used?

This procedure is indicated in specific clinical scenarios.

Displaced humeral fractures that cannot be aligned properly with non-surgical methods.
Fractures associated with significant soft tissue injury.
Fractures that are unstable and at risk of nonunion or malunion.
Fractures in patients with high functional demands requiring precise alignment.

Symptoms Indicating This Procedure

Patients may present with various symptoms that suggest the need for surgical intervention.

Severe pain in the upper arm.
Swelling and bruising around the fracture site.
Inability to move the arm or shoulder.
Deformity or abnormal positioning of the arm.

Causes and Risk Factors

Understanding the causes and risk factors can help in prevention and management.

Traumatic injuries from falls or accidents.
Sports-related injuries.
Osteoporosis or other conditions that weaken bones.
Age-related factors, as older adults are more prone to fractures.

Diagnostic Tests Before Procedure

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

X-rays to visualize the fracture and its alignment.
CT scans for detailed imaging of complex fractures.
MRI to assess soft tissue injuries associated with the fracture.

Procedure Description

The open treatment of a humeral fracture involves several key steps.

Administer anesthesia to ensure patient comfort.
Make an incision over the fracture site to access the bone.
Realign the fractured bone fragments into their proper position.
Stabilize the fracture using plates, screws, or rods.
Close the incision with sutures or staples.

Preparation for the Procedure

Proper preparation is essential for a successful outcome.

Avoid eating or drinking for at least 8 hours before surgery.
Discuss any medications with your doctor, especially blood thinners.
Arrange for transportation to and from the surgical facility.
Wear loose, comfortable clothing on the day of the procedure.

Recovery and Aftercare

Post-operative care is crucial for healing.

Expected recovery period is typically 6 to 12 weeks.
Keep the surgical site clean and dry; follow wound care instructions.
Pain management may include prescribed medications.
Physical therapy may be recommended to restore function.

Possible Complications

As with any surgical procedure, there are potential risks.

Infection at the surgical site.
Nerve or blood vessel damage.
Nonunion or malunion of the fracture.
Stiffness or loss of motion in the shoulder or arm.

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Post-Procedure Follow-Up

Regular follow-up is important to monitor recovery.

Initial follow-up appointment within 1-2 weeks post-surgery.
Subsequent visits every 4-6 weeks to assess healing.
X-rays may be taken during follow-ups to ensure proper alignment.

Alternative Treatments

Non-surgical options may be considered in certain cases.

Casting or splinting for non-displaced fractures.
Physical therapy to strengthen the arm and improve mobility.
Pain management with medications and rest.

Home Care Tips

Patients can take steps at home to aid recovery.

Follow all post-operative care instructions from your surgeon.
Keep the arm elevated to reduce swelling.
Engage in gentle movements as advised by your physical therapist.
Monitor for signs of infection, such as increased redness or discharge.

Patient Education & Prevention

Education is key to preventing future injuries.

Engage in strength training to improve bone health.
Use protective gear during sports and activities.
Maintain a healthy diet rich in calcium and vitamin D.
Be cautious in environments where falls are likely.

Billing and Coding Information

CPT Code: 23545

Category: Surgery

Common Modifiers:

50 - Bilateral procedure
59 - Distinct procedural service

Average Cost and Insurance Coverage

Costs can vary based on several factors.

Average cost ranges from $10,000 to $20,000 depending on facility and complexity.
Most insurance plans cover the procedure, but verification is recommended.
Out-of-pocket costs may vary based on deductibles and co-pays.