CPT CODES

CPT Code 23350

CPT code 23350 is for an injection procedure used to enhance the quality of a shoulder x-ray.

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What is CPT Code 23350

CPT code 23350 is used to describe the procedure of injecting a contrast dye or other substance into the shoulder joint to enhance the quality of an x-ray image. This injection helps healthcare providers get a clearer view of the shoulder's internal structures, aiding in the diagnosis and treatment of various shoulder conditions.

Does CPT 23350 Need a Modifier?

For CPT code 23350 (Injection for shoulder x-ray), the following modifiers may be applicable:

1. Modifier 50 - Bilateral Procedure: Used if the injection is performed on both shoulders during the same session.

2. Modifier 51 - Multiple Procedures: Applied when multiple procedures are performed during the same session.

3. Modifier 52 - Reduced Services: Used if the procedure is partially reduced or eliminated at the physician's discretion.

4. Modifier 59 - Distinct Procedural Service: Indicates that the injection is a distinct service from other procedures performed on the same day.

5. Modifier RT - Right Side: Specifies that the injection was performed on the right shoulder.

6. Modifier LT - Left Side: Specifies that the injection was performed on the left shoulder.

7. Modifier 76 - Repeat Procedure by Same Physician: Used if the same procedure is repeated by the same physician on the same day.

8. Modifier 77 - Repeat Procedure by Another Physician: Used if the same procedure is repeated by a different physician on the same day.

9. Modifier 78 - Unplanned Return to the Operating/Procedure Room: Indicates an unplanned return to the operating/procedure room for a related procedure during the postoperative period.

10. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Used if the injection is unrelated to the original procedure and occurs during the postoperative period.

These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.

CPT Code 23350 Medicare Reimbursement

CPT code 23350 is reimbursed by Medicare, but the reimbursement is subject to specific guidelines and conditions outlined in the Medicare Physician Fee Schedule (MPFS). To determine the exact reimbursement rate and any potential restrictions, healthcare providers should consult the MPFS, which provides detailed information on payment rates for services covered by Medicare. Additionally, it is important to verify with the local Medicare Administrative Contractor (MAC) for any region-specific policies or additional documentation requirements that may affect reimbursement for CPT code 23350.

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