Overview of CPT Code 24359: Arthroscopy, shoulder, with repair of rotator cuff
CPT Code 24359 refers to a minimally invasive surgical procedure performed on the shoulder to repair a torn rotator cuff. This procedure is typically done using an arthroscope, a small camera that allows the surgeon to visualize the inside of the shoulder joint.
When CPT Code 24359 is Used?
This procedure is indicated in various clinical scenarios.
- Significant rotator cuff tears that cause pain and limit shoulder function.
- Failure of conservative treatments such as physical therapy and medication.
- Acute injuries resulting in rotator cuff tears, especially in athletes.
- Chronic shoulder pain associated with rotator cuff degeneration.
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.
- Acute injuries from falls or sports activities.
- Repetitive overhead activities, common in certain occupations and sports.
- Previous shoulder injuries or surgeries.
Diagnostic Tests Before Procedure
Several diagnostic tests may be performed to confirm the need for surgery.
- MRI of the shoulder to visualize the rotator cuff and assess the extent of the tear.
- Ultrasound imaging to evaluate soft tissue structures.
- X-rays to rule out bone spurs or other bony abnormalities.
Procedure Description
The procedure is performed under general or regional anesthesia.
- The surgeon makes small incisions around the shoulder.
- An arthroscope is inserted to visualize the joint.
- Damaged tissue is removed, and the torn rotator cuff is repaired using sutures.
- The incisions are closed, and a sterile dressing is applied.
Preparation for the Procedure
Proper preparation is essential for a successful outcome.
- Discuss any medications with your doctor, especially blood thinners.
- Avoid eating or drinking for several hours before the procedure.
- Arrange for someone to drive you home post-surgery.
- Wear loose-fitting clothing for comfort after the procedure.
Recovery and Aftercare
Recovery varies by individual but generally follows a similar pattern.
- Initial rest and immobilization of the shoulder for a few days.
- Gradual introduction of physical therapy to restore strength and mobility.
- Pain management with prescribed medications as needed.
- 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 visits every few weeks to assess healing.
- Physical therapy sessions typically start within a few weeks after surgery.
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 home care can aid in recovery.
- Apply ice packs to reduce swelling and pain.
- Keep the surgical area clean and dry.
- Follow prescribed exercises to improve mobility.
- Avoid heavy lifting or strenuous activities until cleared by your doctor.
Patient Education & Prevention
Education is key to preventing future injuries.
- Engage in shoulder-strengthening exercises.
- Practice proper techniques in sports and physical activities.
- Avoid repetitive overhead motions when possible.
- Seek early treatment for shoulder pain to prevent worsening conditions.
Billing and Coding Information
CPT Code: 24359
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
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 does recovery take?
Recovery can take several months, depending on the extent of the repair.
Will I need physical therapy?
Yes, physical therapy is often necessary to regain strength and mobility.
Are there risks associated with the surgery?
As with any surgery, there are risks, including infection and re-tear.
