Overview of CPT Code 24358: Arthroscopic Shoulder Surgery with Rotator Cuff Repair
CPT Code 24358 refers to a minimally invasive surgical procedure performed on the shoulder to repair a torn rotator cuff using arthroscopic techniques. This procedure is typically indicated for patients experiencing significant shoulder pain and dysfunction due to rotator cuff tears.
When CPT Code 24358 is Used?
This procedure is appropriate in various clinical scenarios.
- Full-thickness rotator cuff tears confirmed by imaging.
- Persistent shoulder pain and weakness despite conservative treatment.
- Limited range of motion affecting daily activities.
- Acute traumatic rotator cuff injuries.
Symptoms Indicating This Procedure
Patients may report several symptoms that lead to the consideration of this surgery.
- Chronic shoulder pain, especially during overhead activities.
- Weakness in the shoulder or arm.
- Difficulty lifting objects or performing daily tasks.
- A clicking or popping sensation in the shoulder joint.
Causes and Risk Factors
Understanding the 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 certain occupations.
- 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 surgery.
- MRI or ultrasound imaging to visualize the rotator cuff.
- X-rays to rule out bone spurs or arthritis.
- Physical examination to assess range of motion and strength.
Procedure Description
The procedure involves several key steps to ensure effective repair.
- Anesthesia is administered to ensure patient comfort.
- Small incisions are made around the shoulder joint.
- An arthroscope is inserted to visualize the inside of the shoulder.
- The torn rotator cuff is identified and repaired using sutures.
- The incisions are closed, and a sterile dressing is applied.
Preparation for the Procedure
Proper preparation is essential for a successful surgery.
- Consult with the surgeon about medications and allergies.
- Avoid blood thinners and certain supplements as advised.
- Arrange for transportation to and from the procedure.
- Follow pre-operative fasting instructions.
Recovery and Aftercare
Post-operative care is crucial for optimal recovery.
- Initial recovery may take 4 to 6 months.
- Physical therapy is often recommended to regain strength and mobility.
- Keep the surgical area clean and dry.
- Pain management with prescribed medications as needed.
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.
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Post-Procedure Follow-Up
Regular follow-up is important to monitor recovery.
- Initial follow-up within 1 to 2 weeks post-surgery.
- Subsequent visits every 4 to 6 weeks to assess healing.
- Physical therapy sessions as recommended by the surgeon.
Alternative Treatments
There are non-surgical options available for managing rotator cuff issues.
- 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
Patients can take several steps at home to aid recovery.
- Apply ice packs to reduce swelling.
- Follow prescribed exercises from physical therapy.
- Avoid lifting heavy objects during recovery.
- Maintain a healthy diet to support healing.
Patient Education & Prevention
Education is key to preventing future injuries.
- Engage in shoulder-strengthening exercises.
- Use proper techniques during sports and physical activities.
- Avoid repetitive overhead motions when possible.
- Regular check-ups for early detection of shoulder issues.
Billing and Coding Information
CPT Code: 24358
Category: Surgery
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 medically necessary.
- Out-of-pocket costs depend on the insurance plan.
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.
How long is the recovery time?
Recovery typically takes 4 to 6 months, depending on individual healing.
Will I need physical therapy?
Yes, physical therapy is often recommended to regain strength and mobility.
What are the risks of the surgery?
Risks include infection, re-tear, and nerve injury, though they are rare.
