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A capsulorrhaphy of the glenohumeral joint, specifically the posterior aspect, is a surgical procedure aimed at addressing issues related to posterior instability and recurrent posterior dislocation of the shoulder joint. The glenohumeral joint, commonly known as the shoulder joint, is a ball-and-socket joint that allows for a wide range of motion. However, it is also susceptible to dislocations, with posterior dislocations occurring less frequently than their anterior counterparts. These dislocations can manifest as subacromial, subglenoid, or subspinous dislocations of the humeral head, leading to instability and functional impairment. The procedure is indicated for various conditions, including simple posterior dislocations, chronic locked dislocations, and chronic posterior instability. Surgical techniques may vary based on the specific condition being treated. The reverse Bankart technique is one of the approaches utilized, which involves making a posterior skin incision and performing a series of dissection and repairs to restore the integrity of the joint capsule. Other techniques, such as the Neer and Rockwood methods, also employ similar approaches but differ in their specific maneuvers and suturing techniques. Overall, the goal of capsulorrhaphy is to stabilize the shoulder joint, restore its function, and prevent future dislocations.
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The capsulorrhaphy procedure is indicated for the following conditions:
The capsulorrhaphy procedure involves several detailed steps to effectively repair the posterior aspect of the glenohumeral joint capsule:
Post-procedure care following a capsulorrhaphy includes monitoring for any signs of complications, managing pain, and initiating rehabilitation protocols as directed by the surgeon. Patients are typically advised to follow a specific recovery plan that may include physical therapy to restore range of motion and strength in the shoulder. The expected recovery time can vary based on the individual and the extent of the procedure performed, but adherence to post-operative instructions is crucial for optimal healing and functional recovery.
| Short Descr | REPAIR SHOULDER CAPSULE | Medium Descr | CAPSULORRHAPHY GLENOHUMERAL JT PST W/WO BONE BLK | Long Descr | Capsulorrhaphy, glenohumeral joint, posterior, with or without bone block | 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 | Non office-based surgical procedure added in CY 2008 or later; 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 |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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. | 81 | Minimum assistant surgeon: minimum surgical assistant services are identified by adding modifier 81 to the usual procedure number. | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | 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) |
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| Pre-1990 | Added | Code added. |
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