# CPT help - Open removal of glenoid componenet



## kdahlen (Oct 6, 2008)

Would appreciate any help with the following CPT codes

Procedure: Open removal of glenoid componenet, open  removal of rotator cuff anchor, right iliac crest bone grafting to right glenoid, revision of humeral head.

Patient has painful total shoulder joint with anterior escape and loose bodies

Also if anyone has any information on great educational material on shoulder coding it would be greatly appreciated. 
Thanks
Kathy

OP report

The right shoulder and right iliac crest were prepped and draped. Attention was directed to the area of the iliac crest and approximately  5 cm longitudinal incision was then placed aprroximately 3 cm posterior to the anterior /superior iliac spine. Careful dissection was taken down to the level of the perosteum and cortical bone window under the direct vision with the osteotomes. Capner gouges were utilized anad a bone medullary graft was harvested from the iliac crest.
An initial skin incision was madfe with a 15 blade and lemostatsis was gained by electrocauter. Disection
was taken down to the level of the deltopectoral interval.  Careful delineation of the deltopectoral interval was completed as there was significan scar tissue.  The deltoid was lifted from scarring over the anteror aspect of the proxima humerus.  The head to the proximal humerus was anteriorly dislocated 
consistent with pre-op films. With the deltoid freed up, careful retraction was placed medially and laterally. The Clavicle pectoral fascia was incised lateral to the strap muscles. The capsule was released just medial to the bicps groove and tag sutures were placed through the capsule. The rotation was complete and the prosthetic head was removed to facilitate visulaization. There was systic formation in the area of greater tuberosity. This was debrided. A loose bioabsorable suture anchor was then removed.
The glenoid was carefully lifted. THe glenoid wasa split with the osteotome and was removed. The peg holes were excavated with the bur following removal of the plastic component. The cement was removed with the bur and the scar tissue removed. The peg holes were then bone grafted and tamped with a bone tamp. a smooth glenoid face resulted.A smaller head was then placed and the shoulder was reduced.The anterior capsule was returned to its insertion site with Fioberwire sutures and tag sutures laterally.


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## mbort (Oct 6, 2008)

look at 23470 for the revision of the glenoidhumeral component, add codes for removal of previous implant/anchors and iliac bone graft as CCI edits allow.


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