Overview of CPT Code 23935: Injection of corticosteroid into shoulder joint
CPT Code 23935 refers to the injection of corticosteroids directly into the shoulder joint to reduce inflammation and alleviate pain associated with various shoulder conditions.
When CPT Code 23935 is Used?
This procedure is indicated in several clinical scenarios.
- Chronic shoulder pain due to arthritis
- Rotator cuff tendinitis
- Shoulder bursitis
- Frozen shoulder (adhesive capsulitis)
- Post-surgical inflammation
Symptoms Indicating This Procedure
Patients may report various symptoms that lead to this procedure.
- Persistent shoulder pain
- Limited range of motion
- Swelling around the shoulder joint
- Pain that worsens with movement
- Stiffness in the shoulder
Causes and Risk Factors
Understanding the underlying causes can help in managing shoulder conditions.
- Age-related degeneration of shoulder structures
- Previous shoulder injuries
- Repetitive overhead activities
- Certain medical conditions like diabetes
- Obesity, which can increase joint stress
Diagnostic Tests Before Procedure
Several tests may be conducted to confirm the need for this injection.
- X-rays to assess joint structure
- MRI to evaluate soft tissue conditions
- Ultrasound for real-time imaging of the shoulder
- Physical examination to assess range of motion and pain
Procedure Description
The injection procedure involves several key steps.
- Patient is positioned comfortably, often sitting or lying down.
- Skin over the shoulder is cleaned with antiseptic.
- A local anesthetic may be applied to minimize discomfort.
- A syringe containing corticosteroid is carefully inserted into the shoulder joint.
- The corticosteroid is injected, and the needle is withdrawn.
- Pressure is applied to the injection site to minimize bleeding.
Preparation for the Procedure
Patients should follow specific guidelines before the injection.
- Inform the doctor about any allergies, especially to medications.
- Discuss current medications, particularly blood thinners.
- Avoid eating or drinking for a few hours before the procedure if sedation is planned.
- Wear loose-fitting clothing to allow easy access to the shoulder.
Recovery and Aftercare
Post-procedure care is essential for optimal recovery.
- Rest the shoulder for 24 hours after the injection.
- Apply ice to the injection site to reduce swelling.
- Avoid strenuous activities for a few days.
- Follow up with the healthcare provider if symptoms worsen.
Possible Complications
While generally safe, there are potential risks associated with the procedure.
- Infection at the injection site
- Bleeding or bruising
- Temporary increase in pain
- Allergic reaction to the corticosteroid
- Tendon rupture in rare cases
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Post-Procedure Follow-Up
Monitoring after the procedure is crucial.
- Schedule a follow-up appointment within 1-2 weeks.
- Assess pain relief and range of motion improvements.
- Discuss any ongoing symptoms or concerns.
- Consider additional treatments if necessary.
Alternative Treatments
There are several non-surgical options available.
- Physical therapy to strengthen shoulder muscles
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Corticosteroid oral medications
- Heat or cold therapy
- Activity modification to reduce strain on the shoulder
Home Care Tips
Patients can take steps at home to aid recovery.
- Keep the injection site clean and dry.
- Use ice packs for 15-20 minutes to reduce swelling.
- Engage in gentle shoulder exercises as advised.
- Monitor for any signs of infection, such as increased redness or warmth.
Patient Education & Prevention
Educating patients can help prevent future issues.
- Maintain a healthy weight to reduce joint stress.
- Engage in regular shoulder-strengthening exercises.
- Avoid repetitive overhead activities when possible.
- Seek early treatment for shoulder pain to prevent worsening.
Billing and Coding Information
CPT Code: 23935
Category: Injection Procedures
Common Modifiers:
- 50 (bilateral procedure)
- RT (right side)
- LT (left side)
Average Cost and Insurance Coverage
Costs can vary based on location and insurance.
- Average cost ranges from $200 to $500.
- Most insurance plans cover the procedure if deemed medically necessary.
- Check with your insurance provider for specific coverage details.
Related CPT Codes
Frequently Asked Questions (FAQs)
How long does the injection take?
The injection itself usually takes just a few minutes.
Will I feel pain during the injection?
You may feel a brief sting from the local anesthetic, but the procedure is generally well-tolerated.
How soon can I return to normal activities?
Most patients can resume normal activities within a day or two, but avoid strenuous activities for a few days.
How effective is the injection?
Many patients experience significant pain relief, but results can vary.
