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Thread: Total Shoulder

  1. #1
    Join Date
    Apr 2007
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    Long Island/New York
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    Default Total Shoulder

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    I need a little clarification. One of my Dr's did a "reverse shoulder prosthesis that was implanted" and used code 23472 (total shoulder). Does anyone know if there is a more appropriate CPT code for this type of procedure?

    the reverse part is a little confusing....would it be considerded a revision?

    thanks

  2. #2

    Default

    i have talked to my doctor who does alot of these and we charge a 23472 the total shoulder.

  3. #3
    Join Date
    Apr 2007
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    ENGLEWOOD/DENVER
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    Default

    23472 is appropriate.

  4. #4

    Default

    It's a reverse replacement because the socket is now going to be the humerus and the ball will be part of the glenoid. It's more difficult to perform that the standard total shoulder because of the glenoid component, so if the operative record supports it you may be able to add the -22 and seek additional reimbursement, but the base code will be 23472.

  5. #5
    Join Date
    Apr 2007
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    Long Island/New York
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    Default

    thank you all..

  6. #6

    Default

    Has anyone had any luck getting reimbursement on using the mod 22 with the 23472?

  7. #7
    Join Date
    Apr 2007
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    ENGLEWOOD/DENVER
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    Default

    yes although the documentation was immaculate (yes there are a few docs that still do a good job). The reimibursement was only 15% more than normal which doesnt really amount to much.

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