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Identify Shoulder Injury ICD-10-CM Codes. Orthopedic surgeons perform shoulder arthroplasty to alleviate pain, stiffness, and other symptoms the patient is experiencing due to the damaged joint. You must show medical necessity for the shoulder surgery to ensure reimbursement; otherwise, the payer will deny your claim.
Include the operative report and a letter with your claim, in which the surgeon should explain that he performed advanced rotator cuff arthroplasty using a reverse total shoulder replacement. Have the physician explain the patient’s condition and discuss why the procedure was more complicated than a standard arthroplasty.
ICD-10 code Z96.611 for Presence of right artificial shoulder joint is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services . ×
1. Reverse total shoulder arthroplasty of the right shoulder. 2. Biceps tenodesis, open. PROCEDURE: The patient was brought to the OR and placed in the supine position. General endotracheal intubation was achieved without complication. The patient was placed in the beach chair position and prepped and draped in the normal sterile fashion.
1. Right revision shoulder arthroplasty with removal of hardware. 2. Right shoulder extensive debridement with intraoperative cultures. 3. Right shoulder implantation of cement spacer for possible two-stage revision. Billing to BCBS, prosthesis was removed from shoulder and a spacer implanted for a later staged revision.
1. Right reverse total shoulder arthroplasty 2. Biceps tenotomy Implants: 1. Zimmer mini small augmented baseplate with 36 mm standard glenosphere, 6.5 x 25 mm central screw 2. Zimmer 7x83 identity humeral stem with 36 -6 tray, standard polyethylene liner EBL: 150 mL Complications: None
A total shoulder replacement is indicated by 23472 (total shoulder, glenoid and proximal humeral replacement) A hemiarthroplasty is indicated by 23470 (arthroplasty, glenohumeral joint) 23330-23332 (removal of foreign body, shoulder)
The Current Procedural Terminology (CPT ®) code 23474 as maintained by American Medical Association, is a medical procedural code under the range - Repair, Revision, and/or Reconstruction Procedures on the Shoulder.
You're right, there's no description of the tenodesis. And there's no diagnosis for biceps pathology. If there were, I supposes I'd ask him if he did in fact do a tenodesis and if so, would need to edit the OP note. But since there's no supporting diagnosis AND it's Freedom Blue insurance, I'll only bill for the TSA.
1. Right anatomic total shoulder arthroplasty revision to a reverse total shoulder arthroplasty construct. This revision included exchange of both the glenoid and humeral components. 2. Right shoulder open rotator cuff reconstruction of the subscapularis tendon with Achilles allograft. BLOOD LOSS: Approximately 500 mL. BLOOD REPLACEMENT: None.