CCANTER
Networker
I am needing help with a CPT code for a conversion from a total shoulder arthroplasty to a hemi-arthroplasty.
I am thinking 23470 with mod 22 or would i also add a cpt code for the removal of the glenoid component?
DESCRIPTION OF PROCEDURE:
Anterior incision reopened. Skin flaps elevated. The deltopectoral interval reopened. Retractor was inserted. Fluid collection was evacuated. We were able to first used the shoe horn to get the tray off of the stem of the humerus. This allowed access to the glenoid side.
We had to disassociate the baseplate and the glenosphere with the appropriate screwdrivers. Most of the baseplate had pulled out of the bone glenoid. There was a significant amount of heterotopic ossification in the area. This was all excavated. Took a considerable amount of time to avoid neurovascular structures and remove what I felt I could of the HO. Most of the glenoid was covered in scar tissue, so I had to do quite a bit of dissection to even expose what was left of the glenoid surface.
Once the resection was completed, we trialled several options. Elected on a 52 mm head with a +5 spacer. This was then trialled, then finally impacted onto the stem that was already present in the humerus. Good range of motion and stability was demonstrated. We then closed the deltopectoral interval with 0 Monocryl, 2-0 Monocryl subcutaneous, staples closed the skin.
I am thinking 23470 with mod 22 or would i also add a cpt code for the removal of the glenoid component?
DESCRIPTION OF PROCEDURE:
Anterior incision reopened. Skin flaps elevated. The deltopectoral interval reopened. Retractor was inserted. Fluid collection was evacuated. We were able to first used the shoe horn to get the tray off of the stem of the humerus. This allowed access to the glenoid side.
We had to disassociate the baseplate and the glenosphere with the appropriate screwdrivers. Most of the baseplate had pulled out of the bone glenoid. There was a significant amount of heterotopic ossification in the area. This was all excavated. Took a considerable amount of time to avoid neurovascular structures and remove what I felt I could of the HO. Most of the glenoid was covered in scar tissue, so I had to do quite a bit of dissection to even expose what was left of the glenoid surface.
Once the resection was completed, we trialled several options. Elected on a 52 mm head with a +5 spacer. This was then trialled, then finally impacted onto the stem that was already present in the humerus. Good range of motion and stability was demonstrated. We then closed the deltopectoral interval with 0 Monocryl, 2-0 Monocryl subcutaneous, staples closed the skin.