# Left reverse total shoulder arthroplasty and tuberosity osteosynthesis left shoulder



## PatMacc (Aug 27, 2009)

I am not sure if both 23472 and 23680 are coded for these procedures or if 23680 is included in 23472.  Patient had left proximal umeral type IV fx sequelae.  Left reverse shoulder arthroplasty for proximal humeral fx then tuberosity osteosynthesis left shoulder.   Humeral head severely dislocated, glenoid reamed, 42 mm genosphere form Tornier Aequal is reverse total shoulder arthroplasty.  Bicortical screw fixation in all quadrants.  After placing this attention to humerus and 11 mm fracture stem from reverse fracture arthroplasty set was then utilized and cemetned in anatomic position, followed by 9 mm polyethylene spacer. Bone graft placed  The anterior and posterior rotatro cuff tissues and the greater and lesser tuberosities were then osteosynthesized in the Gothic arch technique.  Excellent anatomic stability. 

We are torn on if both codes or just one are reported.
TIA Pat


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## mbort (Aug 27, 2009)

the purpose of the TSA is for the fracture so the 23472 is the only code you should use.  The TSA is the repair of the fracture.   You may want to add the 22 modifier if the documentation supports the additional work involved as there typically is with the reverse type TSA.


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## PatMacc (Aug 28, 2009)

Thank you Mary!


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## daedolos (Feb 23, 2018)

23472-22 is still the going standard for reverse total shoulder arthroplasty surgery?

Peace
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