CPT code 23802 is a medical code used to describe arthrodesis of the glenohumeral joint with graft, aiding in standardized billing and documentation.
CPT code 23802 is used to describe a surgical procedure known as arthrodesis of the glenohumeral joint with graft. This procedure involves the fusion of the shoulder joint (glenohumeral joint) using a graft, which is typically done to alleviate pain or restore stability in cases where other treatments have failed. The graft material can be taken from the patient (autograft) or from a donor (allograft). This code is essential for accurate billing and documentation of the specific surgical intervention performed.
For CPT code 23802 (Arthrodesis, glenohumeral joint with graft), the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 22 - Increased Procedural Services: Used when the work required to perform the procedure is substantially greater than typically required.
2. Modifier 50 - Bilateral Procedure: Used if the procedure is performed on both shoulders during the same session.
3. Modifier 51 - Multiple Procedures: Used when multiple procedures are performed during the same surgical session.
4. Modifier 52 - Reduced Services: Used when the procedure is partially reduced or eliminated at the physician's discretion.
5. Modifier 53 - Discontinued Procedure: Used when the procedure is started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
6. Modifier 59 - Distinct Procedural Service: Used to indicate that a procedure or service was distinct or independent from other services performed on the same day.
7. Modifier 62 - Two Surgeons: Used when two surgeons work together as primary surgeons performing distinct parts of a single reportable procedure.
8. Modifier 66 - Surgical Team: Used when a team of surgeons (more than two) is required to perform the procedure.
9. Modifier 76 - Repeat Procedure by Same Physician: Used when the same physician performs the procedure more than once on the same day.
10. Modifier 77 - Repeat Procedure by Another Physician: Used when a procedure performed by another physician is repeated on the same day.
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: Used when a related procedure is performed during the postoperative period of the initial procedure.
12. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Used when an unrelated procedure is performed by the same physician during the postoperative period.
13. Modifier 80 - Assistant Surgeon: Used when an assistant surgeon is required during the procedure.
14. Modifier 81 - Minimum Assistant Surgeon: Used when a minimum assistant surgeon is required during the procedure.
15. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Used 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: Used when these non-physician practitioners assist in the surgery.
Each modifier serves a specific purpose and should be used accurately to ensure proper billing and reimbursement. Always refer to the latest CPT guidelines and payer-specific policies for the most accurate and up-to-date information.
The CPT code 23802 is reimbursed by Medicare, but it is essential to verify the specific details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and their corresponding reimbursement rates. Additionally, Medicare Administrative Contractors (MACs) play a crucial role in determining the reimbursement policies and rates for specific regions. Therefore, while CPT code 23802 is generally reimbursed by Medicare, healthcare providers should consult the MPFS and their respective MAC for precise information regarding coverage and reimbursement rates.
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