Don't use unlisted code for total shoulder implant revision

Why This Topic Matters

Choosing the right procedure code can affect claim processing, payer review, and whether an unlisted code triggers avoidable denials. The article also highlights a small set of new CPT Category III codes that may matter to orthopedic practices.

Article Sections

1. Don’t use unlisted code for total shoulder implant revision

   Discusses coding considerations for revision of a total shoulder implant and summarizes the context behind concerns with unlisted procedure reporting. It also references professional and payer guidance related to orthopedic coding practices.

2. New CPT Category III codes: 2 for orthopedic practices

   Introduces newly effective CPT Category III orthopedic codes and explains that they were added in the context of emerging technology reporting. The section identifies the new code set and its timing.