Wiki open repair rotator cuff tear

Trendale

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Hello,
Can someone explain the difference between codes 23410 and 23420. Regarding 23420, I was told it is for the repair of all three major muscles and for chronic tears. After reading the report, it syas 1 small tear, so I didin't know if I should ue the 23410, because i was told that is for 1 to 2 muscles/tendons:cool:

OPERATIVE PROCEDURE: After satisfactory general anesthesia, the
patient was positioned in the beach chair semi-Fowler position and the
right shoulder was prepped and draped in usual fashion. The patient
did receive preoperative antibiotics.
The area for the skin incision was infiltrated with 0.5% Marcaine with
epinephrine, and then a skin incision was made from the area on the
top of the acromion and extending over the anterolateral aspect of the
acromion for a total distance of about 2 inches and dissection made
through the subcutaneous tissue. The deltoid was released from its
attachments on the anterolateral aspect of the acromion, just to the
AC joint. Minor bleeding controlled with electrocautery. Then, the
AC ligament was released from its attachment on the acromion. The
undersurface of the acromion was osteotomized in the Neer fashion,
removing more bone anteriorly and laterally, and then the undersurface
was smoothed with a rasp. The rotator cuff was then carefully
inspected and there was one small 1 cm full-thickness tear that could
easily be reapproximated just with #1 Ethibond sutures. There was no
need for an anchor as the distal aspect of the tendon was still
attached to the greater tuberosity.
After it was felt to be a satisfactory repair of the defect, then the
wound was irrigated thoroughly with normal saline. An On-Q single
portal pump, 100 mL, was placed into proper position and primed, and
then the deltoid was reapproximated using #1 Vicryl suture. The
subcutaneous tissue was approximated with 0-Vicryl suture and the skin
was approximated with a running subcuticular 2-0 nylon. A sterile
bulky dressing was applied. The On-Q pump was finally assembled and
then a sling was placed. The patient was then brought to the recovery
room in satisfactory stable condition. She tolerated the procedure
well and there were no complications. Blood loss was negligible, and
there were no specimens, and sponge and needle counts were correct.
 
Differentiation

:) 23410 is the correct code.

23412 is used for more chronic tears, or those that involve multiple tendons. If this is really your doc's report, I would recommend advising him to indicate what tendons are involved in the repair.

23420 is used when additional procedures such as grafting are employed to accomplish the repair.

I hope this helps! ;)

Doris
 
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