2025 CPT code 23929
Unlisted procedure, shoulder.
Modifiers can be applicable to further specify the circumstances of the procedure. It is crucial to refer to current CPT guidelines and payer-specific policies for correct modifier usage.
Documentation should support the medical necessity of the procedure by demonstrating how the performed surgery addressed the patient's specific condition and improved their functional outcome. This may include pre-operative imaging studies, clinical examination findings, and patient-reported symptoms.
The provider performs a shoulder procedure not represented by a standard CPT code. It's crucial to ensure no other code describes the service more accurately.
In simple words: This code is used when a doctor performs a shoulder operation that doesn't have its own specific code.
This code is used for shoulder procedures that don't have a specific CPT code.
Example 1: A patient presents with a complex shoulder injury not adequately addressed by existing CPT codes. After a thorough evaluation, the surgeon performs a novel surgical technique to repair the damage. As this unique procedure lacks a dedicated code, 23929 is used., A patient with a rare shoulder anatomical anomaly requires a customized surgical approach. The surgeon develops and performs a procedure tailored to the patient's specific condition. Due to the unusual nature of the surgery, it's reported with 23929., During a routine shoulder arthroscopy, the surgeon discovers unexpected pathology requiring an unconventional surgical repair. This unforeseen procedure necessitates the use of 23929 for accurate billing.
Thorough operative notes detailing the procedure performed, including the specific surgical approach, instruments used, and any unusual circumstances or findings are necessary. Justification for using an unlisted code over any existing CPT codes is also required. It's often helpful to include a comparison of the procedure to similar, established CPT codes.
** Using this code requires detailed documentation and clear justification, including a comparison with similar codes and a comprehensive operative report. This ensures accurate reimbursement and reduces the risk of claim denial.
- Specialties:Orthopedic Surgery
- Place of Service:Ambulatory Surgical Center, Inpatient Hospital, On Campus-Outpatient Hospital