Orthopedic Coding Alert

Question: Are codes 23220 (Radical resection of tumor, proximal humerus) and 23472 (Arthroplasty, glenohumeral joint; total shoulder [glenoid and proximal humeral replacement (eg, total shoulder)]) appropriate to use for radical resection, metastatic carcinoma, left proximal humerus and reconstructive reverse total shoulder arthroplasty?

Florida Subscriber

Answer: Your choice of 23220 is correct for the radical resection of the metastatic carcinoma in the proximal humerus. For the reconstructive total arthroplasty, you are correct to report 23472. There is, as yet, no specific code for a total shoulder reverse arthroplasty. You can try modifier 22 (Increased procedural services) though this is rarely being accepted now.