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The procedure described by CPT® Code 23675 involves the closed treatment of a shoulder dislocation that is accompanied by a fracture of the surgical or anatomical neck of the humerus. In simpler terms, this procedure entails the non-surgical realignment of a dislocated shoulder joint while simultaneously addressing a fracture in the upper arm bone, specifically at the neck region. In cases of shoulder dislocation with this type of fracture, the greater and lesser tuberosities, which are bony prominences on the humeral head, remain intact and attached. The dislocation occurs when the humeral head is displaced from its normal position in the glenohumeral joint, and the fracture complicates the injury. The physician employs specific manipulation techniques tailored to the direction of the dislocation and their clinical judgment. These techniques may include the application of traction and countertraction, as well as internal and external rotation of the arm, to restore the humeral head to its proper anatomical position. Following the successful reduction of the dislocation, imaging studies, such as radiographs, are performed to confirm that the dislocation has been properly corrected and to assess the alignment of the fractured neck of the humerus. If necessary, further manipulation of the fracture fragments is conducted to ensure optimal alignment. Once the anatomical alignment is confirmed, the shoulder is then immobilized in a cast to facilitate healing and prevent further injury.
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The closed treatment of shoulder dislocation with a concomitant surgical or anatomical neck fracture is indicated in the following scenarios:
The closed treatment procedure for a shoulder dislocation with a surgical or anatomical neck fracture involves several critical steps:
Post-procedure care involves monitoring the patient for any signs of complications, such as increased pain, swelling, or loss of function. The immobilization cast is typically kept in place for a specified duration to allow for proper healing of the shoulder joint and the fracture. Follow-up appointments are essential to assess the healing process through physical examinations and additional imaging if necessary. Rehabilitation exercises may be introduced gradually to restore range of motion and strength once the physician determines that it is safe to do so.
| Short Descr | CLTX SHO DISLC NECK FX MNPJ | Medium Descr | CLTX SHOULDER DISLC W/SURG/ANTMCL NECK FX W/MNPJ | Long Descr | Closed treatment of shoulder dislocation, with surgical or anatomical neck fracture, with manipulation | 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) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | 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) | P5B - Ambulatory procedures - musculoskeletal | MUE | 1 | CCS Clinical Classification | 148 - Other fracture and dislocation procedure |
| 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). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 54 | Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number. | 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. | 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.) | 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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| 2023-01-01 | Note | Short and medium descriptions changed. |
| Pre-1990 | Added | Code added. |
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