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The procedure described by CPT® Code 23462 refers to a capsulorrhaphy, specifically an anterior repair of the shoulder capsule that includes the transfer of the coracoid process. This surgical intervention is primarily indicated for patients experiencing instability of the glenohumeral joint, which is the ball-and-socket joint of the shoulder, and for those who have recurrent anterior dislocations of the shoulder. The anterior repair aims to restore the stability of the shoulder by addressing the damaged or disrupted structures within the joint capsule. The technique employed during the procedure can vary based on the specific nature of the injury. Anatomic repairs focus on directly repairing the damaged shoulder structures, while nonanatomic repairs involve shortening or tightening the shoulder structures to enhance joint stability and prevent further dislocations. In this particular procedure, the coracoid process, a bony projection on the scapula, is excised and then transferred to a different location to provide additional support and stability to the shoulder joint. This transfer is crucial as it utilizes the coracoid process along with the attached muscles to reinforce the joint's integrity, thereby reducing the likelihood of future dislocations.
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The procedure described by CPT® Code 23462 is indicated for the following conditions:
The procedure begins with an incision made over the anterior aspect of the shoulder joint. This incision allows access to the underlying soft tissues, which are carefully dissected to expose and open the joint capsule. Once the joint capsule is accessed, the specific injury is addressed. In the case of CPT® Code 23462, the coracoid process is excised using an osteotome, a surgical instrument designed for cutting bone. Following the excision, the joint structures are repaired, which may involve shortening and/or tightening the subscapularis muscle or directly repairing the damaged joint structures. After the repair is completed, the excised coracoid process, along with the attached coracobrachialis muscle and the short head of the biceps, is transferred to a new site on the shoulder. This transfer is performed to enhance the stability of the shoulder joint. The coracoid process is then anchored securely using sutures at its base to ensure proper positioning. Once the transfer is complete, the overlying soft tissues are closed in layers, and a dressing is applied to the surgical site to promote healing.
After the completion of the procedure, patients are typically monitored for any immediate complications. Post-operative care may include pain management, physical therapy, and instructions for activity restrictions to ensure proper healing. The expected recovery period can vary based on individual patient factors and the extent of the surgery performed. Patients are advised to follow up with their healthcare provider to assess the healing process and to determine when they can safely resume normal activities.
| Short Descr | REPAIR SHOULDER CAPSULE | Medium Descr | CAPSULORRHAPHY ANTERIOR W/CORACOID PROCESS TR | Long Descr | Capsulorrhaphy, anterior, any type; with coracoid process transfer | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 162 - Other OR therapeutic procedures on joints |
| QX | Crna service: with medical direction by a physician | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | SG | Ambulatory surgical center (asc) facility service |
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| Pre-1990 | Added | Code added. |
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