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Official Description

Open treatment of acromioclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft)

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 23552 involves the open treatment of an acromioclavicular (AC) dislocation, which can be either acute or chronic in nature. An AC dislocation, commonly known as an AC separation or shoulder separation, occurs at the AC joint, a critical joint in the shoulder that connects the acromion of the scapula to the clavicle. This joint is supported by a fibrocartilaginous meniscal disc and is stabilized by surrounding muscles and ligaments. Dislocations of the AC joint typically result from traumatic incidents, such as a direct impact to the shoulder or a fall onto an outstretched arm, which can compromise the integrity of the ligaments and muscles that support the joint. During the procedure, a fascial graft is utilized to provide additional stability to the joint. This involves harvesting a strip of fascia, which is a connective tissue, and configuring it appropriately to reinforce the joint structure. The surgical approach requires an incision over the AC joint, allowing the surgeon to access the area for treatment. The procedure also includes obtaining separate radiographs to confirm the dislocation prior to intervention. Post-surgery, the arm is placed in a sling, and the patient receives instructions regarding activity limitations to ensure proper healing and recovery.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The open treatment of acromioclavicular dislocation using CPT® Code 23552 is indicated for the following conditions:

  • Acute AC Dislocation: This procedure is performed when there is a recent traumatic event leading to a dislocation of the acromioclavicular joint, characterized by significant pain, swelling, and instability in the shoulder area.
  • Chronic AC Dislocation: The procedure is also indicated for patients with a long-standing dislocation that has not healed properly, resulting in persistent discomfort, functional limitations, and instability of the shoulder joint.

2. Procedure

The open treatment of acromioclavicular dislocation involves several key procedural steps:

  • Step 1: Incision and Access: An incision is made over the acromioclavicular joint to provide direct access to the area. This allows the surgeon to visualize the joint and assess the extent of the dislocation and any associated damage to the surrounding structures.
  • Step 2: Debridement: The AC articulation is carefully debrided to remove any damaged tissue or debris that may be present. This step is crucial for preparing the joint for stabilization and ensuring a clean surgical field.
  • Step 3: Repair of Torn Fascia: The torn deltotrapezial fascia, which is a critical stabilizing structure of the shoulder, is repaired. This repair is essential for restoring the integrity of the joint and providing support during the healing process.
  • Step 4: Stabilization of the Joint: Various stabilization techniques may be employed, including the use of a bioabsorbable or nonbioabsorbable device. This may involve placing a screw through the clavicle into the coracoid base or using a pin to secure the acromion across the AC joint and down the clavicle. Alternatively, the coracoacromial ligament may be repositioned over the AC joint to enhance stability.
  • Step 5: Application of Fascial Graft: In this specific procedure, a fascial graft is harvested and configured as needed to stabilize the joint effectively. This graft serves as an additional support structure to reinforce the joint and promote healing.
  • Step 6: Post-Operative Care: After the surgical intervention, the arm is placed in a sling to immobilize the shoulder and facilitate recovery. The patient is provided with specific instructions regarding activity limitations to ensure proper healing and prevent complications.

3. Post-Procedure

Post-procedure care following the open treatment of acromioclavicular dislocation includes placing the arm in a sling to immobilize the shoulder joint, which is essential for recovery. Patients are typically instructed on activity limitations to avoid stressing the joint during the healing process. Follow-up appointments may be scheduled to monitor the healing progress and assess the stability of the joint. Rehabilitation exercises may be introduced gradually, depending on the patient's recovery and the surgeon's recommendations.

Short Descr OPTX ACRCLV DSLC AQ/CHRN GRF
Medium Descr OPTX ACROMCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF
Long Descr Open treatment of acromioclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft)
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 Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P3D - Major procedure, orthopedic - other
MUE 1
CCS Clinical Classification 148 - Other fracture and dislocation procedure
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.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
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)
SG Ambulatory surgical center (asc) facility service
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
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2023-01-01 Note Short description changed.
Pre-1990 Added Code added.
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