Revenue Cycle Insider

Question: I have a surgical report where the orthopedic surgeon performed a shoulder hemiarthroplasty revision. Originally, the hemiarthroplasty was done for a fracture, but then the hemi-humeral stem was loose and the surgeon replaced it.

What CPT^® codes should I use to report the shoulder hemiarthroplasty revision?

New York Subscriber

Answer: Use 23473 (Revision of total shoulder arthroplasty, including allograft when performed; humeral or glenoid component) to report the procedure. This revision code accurately describes the surgery.

Alternatively, you could consider 23616 (Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed, includes repair of tuberosity(s), when performed; with proximal humeral prosthetic replacement) appended with modifier 22 (Increased procedural services) since the procedure was a revision prosthetic for a fracture. However, 23473 best describes the orthopedic surgeon’s work.

Mike Shaughnessy, BA, CPC, Production Editor, AAPC