Overview of CPT Code 23552: Open treatment of humeral head fracture

CPT Code 23552 refers to the surgical procedure for the open treatment of a fracture in the humeral head, which is the upper part of the arm bone that fits into the shoulder joint. This procedure is typically performed when a fracture is displaced or unstable, requiring surgical intervention to restore proper alignment and function.

When CPT Code 23552 is Used?

This procedure is indicated in specific clinical scenarios.

Displaced humeral head fractures that cannot be treated effectively with non-surgical methods.
Fractures associated with significant joint instability.
Fractures resulting from high-energy trauma, such as falls or accidents.
Patients with fractures that have not healed properly with conservative treatment.

Symptoms Indicating This Procedure

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

Severe pain in the shoulder area.
Inability to move the arm or shoulder.
Swelling and bruising around the shoulder joint.
Deformity or abnormal positioning of the shoulder.

Causes and Risk Factors

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

Traumatic injuries from falls, sports, or vehicle accidents.
Osteoporosis, which weakens bones and increases fracture risk.
Age-related degeneration of bone and joint structures.
Previous shoulder injuries or surgeries that may predispose to fractures.

Diagnostic Tests Before Procedure

Several diagnostic tests are essential for confirming the need for surgery.

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

Procedure Description

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

Administer anesthesia to ensure patient comfort.
Make an incision over the shoulder to access the fractured area.
Realign the fractured bone fragments to restore normal anatomy.
Use plates, screws, or other fixation devices to stabilize the fracture.
Close the incision with sutures or staples and apply a dressing.

Preparation for the Procedure

Proper preparation is crucial for a successful surgery.

Discuss medical history and medications with the surgeon.
Avoid eating or drinking for a specified period before surgery.
Arrange for transportation to and from the surgical facility.
Follow any specific instructions provided by the healthcare team.

Recovery and Aftercare

Post-operative care is vital for optimal recovery.

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 mobility and strength.

Possible Complications

As with any surgical procedure, there are potential risks involved.

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

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Post-Procedure Follow-Up

Regular follow-up is essential to monitor recovery.

Initial follow-up appointment within 1 to 2 weeks post-surgery.
Subsequent visits every 4 to 6 weeks to assess healing.
Additional imaging may be required to evaluate bone healing.

Alternative Treatments

Non-surgical options may be considered in certain cases.

Physical therapy to improve strength and mobility.
Bracing or splinting to stabilize the shoulder.
Pain management with medications and rest.

Home Care Tips

Patients can take steps at home to aid recovery.

Follow all post-operative care instructions provided by the surgeon.
Keep the arm elevated to reduce swelling.
Engage in gentle range-of-motion exercises as advised.
Avoid heavy lifting or strenuous activities until cleared by the doctor.

Patient Education & Prevention

Education is key to preventing future injuries.

Maintain bone health through a balanced diet rich in calcium and vitamin D.
Engage in regular weight-bearing exercises to strengthen bones.
Use protective gear during sports and high-risk activities.
Seek prompt medical attention for any shoulder injuries.

Billing and Coding Information

CPT Code: 23552

Category: Surgery

Common Modifiers:

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 if deemed medically necessary.
Out-of-pocket costs may vary based on deductible and co-insurance.