Overview of CPT Code 23655: Arthroscopy, shoulder, diagnostic, with or without biopsy
CPT Code 23655 refers to a diagnostic arthroscopy of the shoulder, which may include a biopsy. This minimally invasive procedure allows physicians to visualize the interior of the shoulder joint, assess any damage, and obtain tissue samples if necessary.
When CPT Code 23655 is Used?
This procedure is indicated in various clinical scenarios.
- Persistent shoulder pain not responding to conservative treatment.
- Suspected rotator cuff tears or labral injuries.
- Evaluation of joint effusion or swelling.
- Assessment of shoulder instability or impingement.
Symptoms Indicating This Procedure
Patients may report several symptoms that lead to the consideration of this procedure.
- Chronic shoulder pain or discomfort.
- Limited range of motion in the shoulder.
- Swelling or tenderness around the shoulder joint.
- Popping or clicking sounds during shoulder movement.
Causes and Risk Factors
Understanding the underlying causes can help in managing shoulder conditions.
- Age-related degeneration of shoulder structures.
- Previous shoulder injuries or trauma.
- Repetitive overhead activities or sports.
- Genetic predisposition to joint disorders.
Diagnostic Tests Before Procedure
Several tests may be conducted to guide the decision for arthroscopy.
- X-rays to assess bone structure and joint alignment.
- MRI to visualize soft tissue injuries.
- Ultrasound for real-time imaging of shoulder structures.
- Physical examination to evaluate range of motion and pain.
Procedure Description
The procedure involves several key steps.
- Patient is positioned comfortably, usually in a sitting or lying position.
- Anesthesia is administered, either general or regional.
- Small incisions are made around the shoulder joint.
- A camera (arthroscope) is inserted to visualize the joint.
- If necessary, tissue samples are taken for biopsy.
- The joint is assessed for any abnormalities.
- Incisions are closed with sutures or adhesive strips.
Preparation for the Procedure
Proper preparation is essential for a successful procedure.
- Discuss any medications with your doctor, especially blood thinners.
- Avoid eating or drinking for several hours before the procedure.
- Arrange for transportation home post-procedure.
- Wear loose-fitting clothing for comfort.
Recovery and Aftercare
Post-procedure care is crucial for optimal recovery.
- Rest the shoulder and avoid strenuous activities for a few weeks.
- Follow-up appointments to monitor healing.
- Ice the shoulder to reduce swelling.
- Pain medications as prescribed by the physician.
Possible Complications
While generally safe, there are potential risks involved.
- Infection at the incision site.
- Bleeding or hematoma formation.
- Nerve or blood vessel injury.
- Persistent pain or stiffness in the shoulder.
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Post-Procedure Follow-Up
Regular follow-up is important for recovery.
- Initial follow-up within one week to check for complications.
- Further assessments at 2-4 weeks post-procedure.
- Physical therapy may be recommended to restore function.
Alternative Treatments
There are non-surgical options available for shoulder issues.
- Physical therapy to strengthen shoulder muscles.
- Corticosteroid injections to reduce inflammation.
- Activity modification to avoid aggravating movements.
- Over-the-counter pain medications for symptom relief.
Home Care Tips
Simple tips can aid in recovery at home.
- Keep the surgical area clean and dry.
- Use ice packs to manage swelling.
- Follow prescribed exercises to regain mobility.
- Avoid lifting heavy objects until cleared by your doctor.
Patient Education & Prevention
Education can help prevent future shoulder issues.
- Engage in shoulder-strengthening exercises.
- Practice proper techniques during sports and activities.
- Maintain a healthy weight to reduce joint stress.
- Seek early treatment for shoulder pain to prevent worsening.
Billing and Coding Information
CPT Code: 23655
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 $5,000 to $15,000.
- Insurance may cover the procedure if deemed medically necessary.
- Out-of-pocket costs depend on the insurance plan.
Related CPT Codes
Frequently Asked Questions (FAQs)
What is the purpose of a shoulder arthroscopy?
It allows doctors to diagnose and treat shoulder problems through small incisions.
How long does the procedure take?
The procedure typically takes about 30 minutes to an hour.
Will I need physical therapy after?
Yes, physical therapy is often recommended to aid recovery.
What can I expect during recovery?
You may experience some pain and swelling, which can be managed with ice and medications.
