# cpt 23420 help



## BFAITHFUL (Feb 15, 2009)

patent has a full thickness tear for re-tear of her rotator cuff and had previous rotator cuff repair back in 1994, the doctor wants to bill cpt 23420 reconstruction of RC, but I'm thinking 23412?

since its a long op report, in short, doctor did an acromioplasty and distal clavice resection, and then describes the repair, see the following

the rotator cuff was debrided sharply of its overlying thickened scar and bursal tissue.  There was noted to be a linear tear and the edges were fashioned up with a #10 blade.  The rent in the rotator cuff was closed at its apex using #2 Ethibond interrupted figure-of-eight sutures and this was sequentially closed down to its lateral most aspect in similar fasion.  At this point, after the linear rent hasd been repaired, the rotator cuff itself had been debrided.  #2 Ethibond was used to reattach to the remaining cuff of the tend on the lateral aspect of the humerus.  This was performed using #2 Ethibond interrupted figure-of-eight sutures.  The integrity of the cuff was inspected and found to be intact after this repair.  The infraspinatus was noted to have any tears.  The biceps tendon of note has been noted to be extremely macerated and torn and this was debrided and removed.  The wound was then copiously irrigated and the deltoid tendon was re-approximated to itself using #2 Ethibond interrupted figure of eight sutures followed by 2-0 Vicryl buried knot sutures for the subq tissue.

I've read for reconstruction it needs to be more than one tendon being repaired and with fascia grafting.

Thanks!!


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## Bella Cullen (Feb 16, 2009)

I would use 23412 also.


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## mbort (Feb 16, 2009)

I would also use 23412, depending on the documentation, you may add the -22 modifier to support the extra work for the revision RCR.


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## BFAITHFUL (Feb 17, 2009)

thank you


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