CPT code 23550 is used for the treatment of an acute or chronic dislocation of the acromioclavicular joint.
CPT code 23550 is used to describe the treatment of an acromioclavicular (AC) joint dislocation, whether it is acute or chronic. This procedure typically involves the surgical repair or stabilization of the AC joint, which is located at the top of the shoulder where the collarbone (clavicle) meets the highest point of the shoulder blade (acromion). This code is essential for accurately documenting and billing for the specific type of shoulder injury treatment provided.
For CPT code 23550, which pertains to the treatment of acromioclavicular dislocation, both acute and chronic, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services
- Use this modifier when the work required to provide a service is substantially greater than typically required. This could be due to complications or other factors that increase the complexity of the procedure.
2. Modifier 24 - Unrelated Evaluation and Management Service by the Same Physician During a Postoperative Period
- This modifier is used when an evaluation and management service provided during a postoperative period is unrelated to the original procedure.
3. Modifier 25 - Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service
- Apply this modifier when a significant, separately identifiable evaluation and management service is performed by the same physician on the same day as the procedure.
4. Modifier 50 - Bilateral Procedure
- Use this modifier if the procedure is performed on both sides of the body.
5. Modifier 51 - Multiple Procedures
- This modifier is used when multiple procedures are performed during the same surgical session.
6. Modifier 52 - Reduced Services
- Apply this modifier when a service or procedure is partially reduced or eliminated at the physician's discretion.
7. Modifier 53 - Discontinued Procedure
- Use this modifier when a procedure is discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
8. Modifier 59 - Distinct Procedural Service
- This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day.
9. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional
- Apply this modifier when a procedure or service is repeated by the same physician or other qualified healthcare professional.
10. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional
- Use this modifier when a procedure or service is repeated by another physician or other qualified healthcare professional.
11. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period
- This modifier is used when a patient returns to the operating room for a related procedure during the postoperative period.
12. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Apply this modifier when an unrelated procedure or service is performed by the same physician during the postoperative period.
13. Modifier 80 - Assistant Surgeon
- Use this modifier when an assistant surgeon is required for the procedure.
14. Modifier 81 - Minimum Assistant Surgeon
- This modifier is used when a minimum assistant surgeon is required for the procedure.
15. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- Apply this modifier when an assistant surgeon is required, and a qualified resident surgeon is not available.
16. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery
- Use this modifier when a physician assistant, nurse practitioner, or clinical nurse specialist assists in the surgery.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 23550 is reimbursed by Medicare, but it is essential to verify the specifics through the Medicare Physician Fee Schedule (MPFS) and consult with your regional Medicare Administrative Contractor (MAC). The MPFS provides detailed information on the reimbursement rates and guidelines for each CPT code, while the MAC can offer localized insights and any additional requirements or restrictions that may apply. Always ensure to cross-reference these resources to confirm the most accurate and up-to-date reimbursement information for CPT code 23550.
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