Bankart Lesion Repair

Paul Cadorette CPC, CPC-H, CPC-P, CEDC, COSC, CASCC -

Editor's Note: This article by Paul Cadorette, director of education for mdStrategies, originally appeared in The Coding Advocate, mdStrategies free monthly newsletter. Sign-up to receive this newsletter by clicking here.

CPT copyright 2008 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

One type of labral tear is known as a Bankart lesion. Within the shoulder capsule there are a number of ligaments that act as restraints, reinforcing the shoulder joint holding the humeral head in the glenolabral cup or socket. At the front lower portion of the shoulder (anteroinferior), you will find the inferior glenohumeral ligament. When this ligament fails during a dislocation injury, the humeral head will push down towards the front of the shoulder tearing the labrum resulting in a Bankart lesion. Typical symptoms of a Bankart lesion include joint instability or repeat dislocations with a popping sound and/or mechanical catching within the joint. Repair of a Bankart lesion can be accomplished by either an open procedure or arthroscopic technique.

The CPT codes are as follows:

  • 23455 – Capsulorrhaphy, anterior; with labral repair (Bankart procedure). There are parenthetical notes under this CPT code that instruct a coder to report 29806 for the arthroscopic procedure.
  • 29806 – Arthroscopy, shoulder, surgical; capsulorrhaphy

The information provided should be utilized for educational purposes only. Facilities are ultimately responsible for verifying the reporting policies of individual commercial and MAC/FI carriers prior to claim submissions.

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