Total Shoulder Revision

dbellemore

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Good Afternoon,
I need some help with a TSR. I am not sure about using 23472-52 as I have read on here today vs 23472-22 as we have used in the past vs 23332 and 23472-52. The 23332 makes sense to me for the removal of the implant then the 23472-52 for replacement at reduced cost. Please give me your thoughts. Thanks for the input
 

dbellemore

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Here is my op note, any help will be appreciated:

The patient was taken to operating room and place supine on the operating room table. After the induction of general anesthesia, the right shoulder, arm, forearm and hand were prepped and draped in the standard fashion. Incision was carried out lateral to the coracoid and subcutaneous tissue was divided. Hemostasis was obtained. Hohmann on the coracoid, the anterolateral acromion mobilized and subdeltoid adhesions to accommodate a Brown retroctor. Idenited the subscap. There was only a inferior portion of it remaining. We removed the remnants of it, cut the head in the appropriate version, broached and prepared the canal for the appropriately sized stem. ***uda Hohmann 360 degree capsular release. Removal of labrum to identify the glenoid vault, removed and released the inferior glenohumeral ligament and the triceps insertion. Found our central low starting point, after removing the cartilage. Drilled our starting point, our peg hole drill, followed by a reamer, pollowed by placement of the implant, and inferior screws, inferior 48 locking, superior 42 locking, followed by placement of the Glenosphere. It was stable. Placed the humeral component and reduced it with a size 0 polyp. It was stable. Placed the actual poly and reduced it, stable. Skin closure with 2-0 Monocryl, sterile dressing and Polar Care sling. Patient was taken to the recovery room in stable condition.
 

armen

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Good Afternoon,
I need some help with a TSR. I am not sure about using 23472-52 as I have read on here today vs 23472-22 as we have used in the past vs 23332 and 23472-52. The 23332 makes sense to me for the removal of the implant then the 23472-52 for replacement at reduced cost. Please give me your thoughts. Thanks for the input
Per AAOS you would code 23332 + 23472.

http://www2.aaos.org/aaos/archives/bulletin/jun99/cod.htm
 
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