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2025 CPT code 23430

Open tenodesis of the long tendon of the biceps.

Follow the CPT guidelines for surgical procedures on the musculoskeletal system.Proper documentation is crucial for accurate coding and reimbursement.

Modifiers may be applicable depending on the circumstances of the procedure. Consult the CPT manual for specific modifier usage.

Medical necessity for open biceps tenodesis is established when conservative treatment fails to alleviate symptoms, and the patient experiences significant functional impairment due to a complete or irreparable biceps tendon tear.

The orthopedic surgeon is responsible for performing the surgical procedure, including incision, dissection, tendon preparation, fixation to the humerus, and wound closure. Pre-operative and post-operative care may be provided by other members of the healthcare team.

IMPORTANT For arthroscopic biceps tenodesis, use code 29828.Code 23430 should not be used in conjunction with codes for arthroscopic procedures on the same tendon.

In simple words: The doctor surgically repairs a torn biceps tendon in the shoulder.They clean up the damaged part of the tendon and then reattach it to the upper arm bone to help the shoulder work better.

This procedure involves the surgical repair of a severely damaged long tendon of the biceps.The damaged portion of the tendon is removed, and the remaining tendon stump is sutured to the upper end of the humerus bone after creating holes in the bone.This is an open procedure, meaning a surgical incision is made to access the tendon and bone.The procedure aims to restore function and stability to the shoulder joint.

Example 1: A patient presents with a complete tear of the long head of the biceps tendon following a fall.Open tenodesis is performed to reattach the tendon and restore shoulder function., A patient with chronic shoulder pain and instability due to a significant biceps tendon tear undergoes open tenodesis.The surgeon removes the severely damaged portion of the tendon and reattaches the remaining healthy portion., An athlete sustains a significant biceps tendon rupture during a sporting event requiring open surgical tenodesis to facilitate a return to play. The procedure restores the stability and function of the biceps tendon.

* Detailed history and physical examination documenting the mechanism of injury, duration of symptoms, and clinical findings.* Pre-operative imaging studies (e.g., MRI, X-ray) confirming the diagnosis of biceps tendon tear.* Operative report detailing the surgical technique, including the amount of tendon removed, the method of fixation, and any complications.* Post-operative imaging studies (if obtained).* Notes documenting the patient's progress and rehabilitation plan.

** This code should be used only when an open surgical approach is necessary for biceps tenodesis.Arthroscopic procedures should be coded separately.

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