Orthopedic Coding Alert

Question: One of our doctors performs rotator cuff decompressions that almost always include an acromioplasty and a coracoacromial ligament release. Are there guidelines as to when to use code 23130 and when to use 23145?

Oklahoma Subscriber

Answer: Code 23130 (acromioplasty or acromionectomy, partial, with or without coracoacromial ligament release) is used only when the physician has performed a partial acromioplasty or a true acromionectomy. Otherwise 23145 (excision or curettage of bone cyst or benign tumor of clavicle or scapula; with autograft [includes obtaining graft]) is almost always the correct code.

According to the American Academy of Orthopedic Surgeons (AAOS) Complete Global Service Data for Orthopaedic Surgery, 23130 is bundled under rotator cuff repair and 23145 is not. It is confusing because the code descriptions are very similar.


Answers to You Be the Coder and Reader Questions provided by Denice A. Wells, CPC, surgery coder for Arizona Bone and Joint Specialist Ltd. in Scottsdale Ariz.; Susan Callaway, CPC, CCS-P, an independent coding consultant and educator based in North Augusta, S.C.; and Heidi Stout, CPC, CCS-P, coding and reimbursement manager at University Orthopaedic Associates in New Brunswick, N.J.