2025 CPT code 23100
(Active) Effective Date: N/A Revision Date: N/A Surgery - Arthrotomy Musculoskeletal System Feed
Arthrotomy of the glenohumeral joint, including biopsy.
Modifiers may be applicable depending on the circumstances of the procedure. Consult CPT guidelines and the NCCI edits for details.
The procedure is medically necessary when other less invasive diagnostic methods have failed to establish a diagnosis and a tissue biopsy is required to rule out infection, inflammatory conditions, or tumors in the shoulder joint.Medical necessity is determined by the physician's clinical judgment based on the patient's history, physical exam, and diagnostic tests.
The physician or qualified healthcare professional is responsible for proper preparation and anesthesia of the patient. They perform the surgical incision, visualization and exposure of the joint, biopsy collection, and wound closure.Post-operative care may also be part of the physician's responsibility.
In simple words: The doctor makes a cut in the shoulder to look inside the joint and take a small tissue sample to test.
This procedure involves a surgical incision into the glenohumeral joint (shoulder joint) to expose the joint's interior and obtain a tissue biopsy for diagnostic purposes.The procedure includes the incision, visualization of the joint capsule, incision of the capsule to expose the joint, tissue biopsy, and closure of the surgical wound. This is typically performed to diagnose conditions such as infection, inflammation, or tumors within the shoulder joint.
Example 1: A patient presents with persistent shoulder pain and inflammation. An arthrotomy with biopsy (23100) is performed to rule out infection or other inflammatory conditions., A patient has a suspected mass within the shoulder joint.An arthrotomy with biopsy (23100) is performed to obtain a tissue sample for pathological analysis to determine if the mass is benign or malignant., A patient experiences recurrent shoulder pain post-injury with no clear diagnosis from imaging. An arthrotomy with biopsy (23100) is performed to identify the underlying cause of the persistent pain.
* Preoperative diagnosis and indication for the procedure.* Detailed operative report describing the procedure performed, including incision site, tissue sample obtained, and findings.* Pathology report detailing the results of the biopsy.* Postoperative care instructions.* Any complications encountered during or after the procedure.
** Always verify coding with the latest CPT guidelines and payer-specific requirements.This information is for educational purposes only and should not be considered medical advice.
- Revenue Code: P5B (Ambulatory Procedures - Musculoskeletal)
- RVU: This information is not available in the provided source.Consult the current year's Medicare Physician Fee Schedule for RVU values.
- Global Days: The global period for this procedure is not specified in the provided sources.Consult the appropriate guidelines.
- Payment Status: Active
- Modifier TC rule: Not applicable. This is a complete surgical procedure.
- Fee Schedule: This information is not available in the provided source.Consult historical fee schedules for the relevant years.
- Specialties:Orthopedic Surgery
- Place of Service:Office, Ambulatory Surgical Center, Inpatient Hospital