AHA Coding Clinic® for HCPCS - 2023 Issue 2; Ask the Editor

Shoulder arthroplasty with humeral head resurfacing and inlay glenoid

A patient presents for right humeral head resurfacing and an inlay glenoid total shoulder arthroplasty. A saber incision was made from the coracoid to the axillary fold exposing the deltopectoral interval and subsequently exposing the subscapularis. Once soft tissue adhesions were broken up from the acromion’s undersurface and rotator cuff interval, the capsule was incised. The shoulder was externally rotated, the capsule was dissected off the humeral neck and the humeral head was completely dislocated into the wound. Once the humeral head was measured (52 x 56 mm), the appropriate-sized reamer was used to place the centering pin into the humeral head parallel to the neck of the humerus. The centering drill guide was placed and the humeral head was reamed to the appropriate size.The glenoid was exposed after the humeral head was reduced. Once the capsule was released and improved range of motion was accomplished, the centering pin was inserted. The paddle reamer was used to create the defect into the glenoid for the inlay glenoid. The drill guide was placed for placement of the drill hole for the peg of the prosthesis. The trial glenoid was inserted and fit flush with the subchondral bone. Bone cement was inserted and the permanent glenoid prosthesis was inserted and compressed. The humeral head was re-dislocated into the wound. The centering guide for the fixation screw was placed over the humeral head and secured with pins. Once the drill hole for the excision screw was made, the fixation screw was inserted. The screw height was confirmed, the centering device removed from the humeral head and the permanent prosthesis was inserted and compressed. The humeral head was relocated into the shoulder and the subscapularis tendon was reapproximated. A permanent prosthesis was inserted and compressed into both the glenoid defect and into the humeral head. How is the resurfacing of the humeral head and placement of a glenoid inlay reported? ...

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