Wiki Opinions needed for dislocated total shoulder

[Ramona03]

Good Afternoon Fellow Coders:

I could use some opinions on the following please? How would you code a Shoulder dislocated reverse arthroplasty? The patient has had issues with the shoulder in the past. First procedure they underwent was a shoulder hemiarthroplasty (23470), for a fracture. Then the patient returned to have a Reverse Shoulder Arthroplasty (23472), for instablity. Now the patient returns for the dislocated shoulder arthroplasty, within the postoperative period. I know that modifier 78, should be appended, with icd-9 codes 996.42 and V43.61, but how would I could the dislocation? Thanks for the help, I appreciate it!

 

[hewitt]

You may have to wait till you know exactly what procedure is done. I think much of what advice is given until then is speculation.

 

[christinnagle]

my doc had the same type of case. Procedure was (condensed format): removed humeral component, additional bony work done on gleniod due to osteoporonic bone defect; humeral component replaced and confirmed no instability, wound closed.
procedure was w/in p/o of TSA & No fx due to dislocation. I dont feel 23600 justifies the work/procedure involved, but I am concerned about using 23472-52,76,78.
any thoughts?
tia.