Overview of CPT Code 24354:arthroscopy-shoulder-with-rotator-cuff-repair
CPT Code 24354 refers to a minimally invasive surgical procedure known as arthroscopy, specifically targeting the shoulder to repair a torn rotator cuff. This procedure is performed using small incisions and specialized instruments, allowing for reduced recovery time and less postoperative pain compared to open surgery.
When CPT Code 24354 is Used?
This procedure is indicated in various clinical scenarios, particularly when conservative treatments have failed.
- Significant rotator cuff tears causing pain and functional limitations.
- Persistent shoulder pain despite physical therapy and medication.
- Acute rotator cuff injuries following trauma or repetitive overhead activities.
- Impingement syndrome with associated rotator cuff tears.
Symptoms Indicating This Procedure
Patients typically report a range of symptoms that may necessitate this surgical intervention.
- Chronic 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 underlying causes and risk factors can help in prevention and early intervention.
- Age-related degeneration of the rotator cuff.
- Repetitive overhead activities, common in athletes and manual laborers.
- Acute injuries from falls or accidents.
- Previous shoulder injuries or surgeries.
Diagnostic Tests Before Procedure
Several diagnostic tests are utilized to confirm the need for this procedure.
- MRI of the shoulder to visualize the rotator cuff and surrounding structures.
- Ultrasound imaging to assess the integrity of the rotator cuff.
- X-rays to rule out other shoulder conditions such as arthritis.
Procedure Description
The procedure is performed under general anesthesia and involves several key steps.
- The patient is positioned comfortably, typically in a semi-reclined position.
- Small incisions are made around the shoulder joint.
- A camera (arthroscope) is inserted to visualize the inside of the shoulder.
- Damaged tissue is removed, and the torn rotator cuff is repaired using sutures or anchors.
- The incisions are closed, and a sterile dressing is applied.
Preparation for the Procedure
Proper preparation is essential for a successful outcome.
- Avoid eating or drinking after midnight before the surgery.
- Discuss all medications with your doctor, especially blood thinners.
- Arrange for someone to drive you home post-surgery.
- Wear loose-fitting clothing for easy access to the shoulder.
Recovery and Aftercare
Recovery varies by individual but generally follows a standard timeline.
- Initial recovery may take 4 to 6 months for full function.
- Physical therapy is often recommended to regain strength and mobility.
- Keep the surgical site clean and dry; follow wound care instructions.
- Pain management may include prescribed medications or over-the-counter pain relievers.
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 the procedure.
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Post-Procedure Follow-Up
Follow-up appointments are crucial for monitoring recovery.
- Initial follow-up within 1 to 2 weeks post-surgery.
- Regular check-ups every 4 to 6 weeks during recovery.
- Assessment of shoulder function and physical therapy progress.
Alternative Treatments
Before considering surgery, several non-surgical options may be explored.
- Physical therapy to strengthen shoulder muscles.
- Corticosteroid injections to reduce inflammation.
- Activity modification to avoid aggravating the injury.
- Pain management with medications.
Home Care Tips
Following these tips can aid in recovery at home.
- Apply ice packs to reduce swelling and pain.
- Follow prescribed exercises from your physical therapist.
- Avoid lifting heavy objects or engaging in strenuous activities.
- Keep follow-up appointments to monitor healing.
Patient Education & Prevention
Educating patients on prevention can help reduce the risk of recurrence.
- Engage in shoulder-strengthening exercises regularly.
- Avoid repetitive overhead activities without proper conditioning.
- Maintain a healthy weight to reduce stress on joints.
- Seek early treatment for shoulder pain to prevent worsening conditions.
Billing and Coding Information
CPT Code: 24354
Category: Surgical 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 plans.
- Average cost ranges from $10,000 to $20,000.
- Most insurance plans cover the procedure if deemed medically necessary.
- Out-of-pocket costs depend on deductibles and co-pays.
Related CPT Codes
Frequently Asked Questions (FAQs)
What is a rotator cuff?
The rotator cuff is a group of muscles and tendons that stabilize the shoulder joint.
How long is the recovery time?
Recovery can take 4 to 6 months, depending on the extent of the repair.
Will I need physical therapy?
Yes, physical therapy is typically recommended to aid recovery.
What are the risks of the procedure?
Risks include infection, re-tear, and nerve injury.
