Wiki dislocation total shoulder

[scooter1]

Patient has a dislocated reverse total shoulder. Taken to surgery and under general anesthesia, " a manipulative reduction of the reverse was completed and successful ".

I had coded as 23655. However, it was denied.

Am I incorrect ? This was the first dislocation I have had. Should I have just used the
23700 ? That doesn't seem right as this was a dislocation. Please advise ?

 

[daraustin]

Based on your description, 23655 appears correct. Was the patient in the post-op period? If yes, most likely would need modifier -78 or -79 (based on how it dislocated) attached to the 23655. Also, the diagnosis codes would be 996.42, V43.61 and any E code. For appeal purposes, I highlight the procedure performed in the operative description and write the CPT code next to the highlighted procedure.

Generally, 23700 would be used for a frozen shoulder, arthrofibrosis diagnosis.

Best Wishes,
Darlene Austin, CPC, COSC, Author DOCUMENT SMART, M.D. For Orthopaedic Surgery (darlenecoder@hotmail.com)

 

[scooter1]

Thank you. I thought that was correct.