Overview of CPT Code 23585: arthroscopy-shoulder-surgical-with-rotator-cuff-repair

Overview of CPT Code 23585: arthroscopy-shoulder-surgical-with-rotator-cuff-repair

CPT Code 23585 refers to a surgical procedure involving arthroscopy of the shoulder with a focus on repairing the rotator cuff. This minimally invasive technique allows surgeons to access the shoulder joint through small incisions, facilitating the repair of torn rotator cuff tendons.

When CPT Code 23585 is Used?

This procedure is indicated in various clinical scenarios.

• Significant rotator cuff tears that cause pain and limit shoulder function.
• Chronic shoulder pain not relieved by conservative treatments.
• Acute rotator cuff injuries following trauma or overuse.
• Shoulder instability associated with rotator cuff damage.

Symptoms Indicating This Procedure

Patients may report several symptoms that suggest the need for this procedure.

• Persistent shoulder pain, especially during overhead activities.
• Weakness in the shoulder or arm.
• Limited range of motion in the shoulder joint.
• Pain that worsens at night or with specific movements.

Causes and Risk Factors

Understanding the causes and risk factors can help in prevention and early intervention.

• Age-related degeneration of the rotator cuff tendons.
• Repetitive overhead activities, common in athletes and certain occupations.
• Previous shoulder injuries or surgeries.
• Genetic predisposition to tendon injuries.

Diagnostic Tests Before Procedure

Several diagnostic tests may be performed to confirm the need for surgery.

• MRI of the shoulder to visualize rotator cuff tears.
• Ultrasound imaging to assess tendon integrity.
• X-rays to rule out bone spurs or other abnormalities.
• Physical examination to evaluate 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 inside of the shoulder.
• Damaged rotator cuff tissue is identified and assessed.
• Torn tendons are reattached to the bone using sutures or anchors.
• The incisions are closed, and the shoulder is bandaged.

Preparation for the Procedure

Proper preparation is essential for a successful surgery.

• Discuss any medications with your doctor, especially blood thinners.
• Avoid eating or drinking after midnight before the surgery.
• 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 rest and immobilization of the shoulder for several days.
• Gradual introduction of physical therapy to restore movement.
• Pain management with prescribed medications.
• Follow-up appointments to monitor healing and progress.

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 during surgery.

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Post-Procedure Follow-Up

Follow-up care is crucial for optimal recovery.

• Initial follow-up within 1-2 weeks post-surgery.
• Regular check-ups every few weeks to assess healing.
• Physical therapy sessions as recommended by the surgeon.
• Long-term follow-up to monitor shoulder function.

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.

• Keep the surgical area clean and dry.
• Follow prescribed exercises to regain strength.
• Use ice packs to reduce swelling and pain.
• Avoid lifting heavy objects until cleared by your 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 to prevent worsening.

Billing and Coding Information

CPT Code: 23585

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 deemed medically necessary.
• Out-of-pocket costs depend on the insurance plan and deductible.

Related CPT Codes

• 23410 - Repair of Rotator Cuff
• 23412 - Arthroscopic repair of shoulder labrum
• 23420 - Arthroscopic Shoulder Surgery for Rotator Cuff Repair
• 23430 - Arthroscopy, shoulder, surgical; with rotator cuff repair
• 23440 - Repair of shoulder dislocation