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2025 CPT code 23450

Anterior capsulorrhaphy; Putti-Platt or Magnuson-type procedure.This surgical procedure repairs a shoulder joint capsule tear and tightens the capsule if excessively loose.

Follow current CPT coding guidelines for surgical procedures.Modifiers may be needed to report additional services or circumstances (e.g., 76 for repeat procedure).

Modifiers may be applicable depending on the specific circumstances of the procedure and payer guidelines.Examples include modifiers 51 (multiple procedures), 76 (repeat procedure), and 54 (surgical care only).

Medical necessity for this procedure is determined by the presence of significant shoulder instability that causes functional limitations and fails to improve with conservative treatment (physical therapy, medication). Documentation must clearly support the need for surgical intervention.

The orthopedic surgeon is responsible for performing the procedure, including incision, dissection, capsular repair and tightening, hemostasis, drainage, and wound closure. Preoperative and postoperative care may be provided by other qualified healthcare professionals.

IMPORTANT For arthroscopic thermal capsulorrhaphy, use code 29999.Codes 23462-23466 describe other shoulder capsuloorrhaphy procedures, such as those involving coracoid process transfer or posterior glenohumeral joint surgery.

In simple words: The doctor repairs a tear and tightens the shoulder joint's lining to fix instability or excessive looseness. This involves an incision, repair of the tear, and tightening of the joint capsule to stabilize the shoulder.

This procedure involves surgical repair and tightening of the anterior shoulder joint capsule.The surgeon makes an incision over the shoulder joint, dissects through subcutaneous tissue to expose the joint capsule, and transects the subscapularis tendon to access the capsule. After exploring and irrigating the joint cavity, the surgeon vertically divides the capsule and places stay sutures. The capsule is then tightened, bleeding is controlled, a drain is placed, and the wound is closed layer by layer.The procedure may be a Putti-Platt procedure (shortening the anterior capsule and subscapularis muscle) or a Magnuson-type operation (shifting the subscapularis muscle insertion).

Example 1: A patient presents with recurrent anterior shoulder dislocations.The surgeon performs a Putti-Platt procedure to address the instability., A patient experiences chronic shoulder pain and instability after a previous shoulder injury. An anterior capsulorrhaphy is performed to repair a tear in the joint capsule and restore stability., An athlete sustains a significant anterior shoulder dislocation during a competition.The surgeon performs a Magnuson-type operation to address the injury and restore functional shoulder movement.

* Detailed history and physical examination documenting shoulder instability and mechanism of injury.* Preoperative imaging (X-rays, MRI, CT scan) to evaluate the extent of the capsular tear and associated injuries.* Operative report detailing the surgical procedure and findings, including type of capsulorrhaphy performed (Putti-Platt, Magnuson, or other).* Postoperative imaging to confirm successful repair and stability.* Physician's notes documenting the patient's progress and recovery.

** The choice between a Putti-Platt and Magnuson-type procedure depends on the surgeon's assessment of the patient's specific anatomy and the nature of the instability.This code does not include arthroscopic thermal capsulorrhaphy, which should be coded separately using code 29999.Always verify payer-specific coverage and reimbursement policies before submitting claims.

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