Coracohumeral reconstruction

[dmills]

I have a provider who is treating a multi-directional shoulder instability. In addition to the capsular shift, he is doing a separate reconstruction of the coracohumeral ligament with a semitendinosus allograft. There is no code for this procedure and he wants to use 23550. I'm thinking this will probably have to be unlisted. Thoughts?

We then turned our attention to the coracohumeral ligament reconstruction. On the back table 1 end of a semitendinosus allograft was whipstitched with a #2 FiberWire. After graft prep the graft was soaked in vancomycin solution at 5 mg per 100 mL of solution. The lateral and posterior aspect of the coracoid near the coracoid elbow was exposed with Bovie electrocautery and a Cobb elevator. A 2.9 mm short push lock anchor was then placed into the inferior and lateral aspect of the coracoid elbow. After drilling for the anchor tract a K wire was used to sound the drill tunnel to ensure that cortical bone remained throughout the circumference of the drill tunnel and at the posterior aspect. After confirming this the short 2.9 push lock anchor was inserted with the graft flush to the cortex. The remaining limbs of suture was used to oversew and secure the graft in place along the base of the coracoid on the lateral and inferior aspect. The arm was then placed into neutral forward elevation/extension, 30 degrees of abduction, and 40 degrees of external rotation. The superior and lateral aspect of the subscapularis was identified and the anatomic attachment of the CHL was marked. A 2.6mm fibertak anchor loaded with fiber tape was inserted at this location. The 2 limbs of fiber tape were then passed through the semitendinosus allograft with appropriate tension. These were tied securely to secure the graft in place. Excess limbs of suture and graft were then trimmed. The arm was taken through range of motion and the shoulder was stable with appropriate graft tension

 

[NRaizman]

Any and all reconstruction for MDI is 23466.
You could add a -22. You could try for an unlisted code.
It would be entirely inappropriate to use an AC joint reconstruction code for this, as the diagnosis is different, and the reconstruction has -nothing- to do with the AC joint, clavicle, or even the coracoclavicular ligaments which secondarily stabilize the AC joint.