CPT code 23650 is for the closed treatment of a shoulder dislocation with manipulation, without anesthesia.
CPT code 23650 is used to describe the closed treatment of a shoulder dislocation with manipulation, without the use of anesthesia. This code is typically used when a healthcare provider manually repositions a dislocated shoulder back into its proper place without administering anesthesia to the patient.
For CPT code 23650 (Closed treatment of shoulder dislocation with manipulation; without anesthesia), the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: Use this modifier if the work required to perform the procedure is substantially greater than typically required.
2. Modifier 24 - Unrelated Evaluation and Management Service by the Same Physician During a Postoperative Period: Use this modifier if an evaluation and management service was performed during the postoperative period of another procedure, but 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: Use this modifier if a significant, separately identifiable evaluation and management service is provided 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 shoulders.
5. Modifier 51 - Multiple Procedures: Use this modifier if multiple procedures are performed during the same session.
6. Modifier 52 - Reduced Services: Use this modifier if the procedure is partially reduced or eliminated at the physician's discretion.
7. Modifier 53 - Discontinued Procedure: Use this modifier if the procedure is discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
8. Modifier 54 - Surgical Care Only: Use this modifier if the physician is providing only the surgical care portion of the procedure.
9. Modifier 55 - Postoperative Management Only: Use this modifier if the physician is providing only the postoperative care portion of the procedure.
10. Modifier 56 - Preoperative Management Only: Use this modifier if the physician is providing only the preoperative care portion of the procedure.
11. Modifier 59 - Distinct Procedural Service: Use this modifier if a procedure or service was distinct or independent from other services performed on the same day.
12. Modifier 76 - Repeat Procedure or Service by Same Physician: Use this modifier if the procedure needs to be repeated by the same physician.
13. Modifier 77 - Repeat Procedure by Another Physician: Use this modifier if the procedure needs to be repeated by a different physician.
14. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: Use this modifier if the patient needs to return to the operating room for a related procedure during the postoperative period.
15. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Use this modifier if an unrelated procedure or service is performed by the same physician during the postoperative period.
16. Modifier 80 - Assistant Surgeon: Use this modifier if an assistant surgeon is required for the procedure.
17. Modifier 81 - Minimum Assistant Surgeon: Use this modifier if a minimum assistant surgeon is required for the procedure.
18. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Use this modifier if an assistant surgeon is required because a qualified resident surgeon is not available.
19. Modifier 99 - Multiple Modifiers: Use this modifier if multiple modifiers are needed for the procedure.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 23650 is reimbursed by Medicare, but it is essential to verify the specific details through the Medicare Physician Fee Schedule (MPFS) and your regional Medicare Administrative Contractor (MAC). The MPFS provides a comprehensive list of services covered by Medicare, including the reimbursement rates for each CPT code. Additionally, MACs are responsible for processing Medicare claims and can offer region-specific guidance on coverage and reimbursement policies. Therefore, while CPT code 23650 is generally reimbursed, consulting the MPFS and your MAC will ensure accurate and up-to-date information tailored to your specific location and circumstances.
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