Summary & Overview
CPT 0349T: Upper-Extremity Implant Motion and Wear Interpretation
CPT code 0349T covers the professional interpretation of two-dimensional images of the upper extremity (shoulder, elbow, wrist) to evaluate motion, quality, and wear of an implant or prosthesis with the aid of previously placed tantalum markers. This code captures a specialized, device-focused imaging interpretation that supports postoperative surveillance, suspected implant failure, and decisions about revision or conservative management. Nationally, the code matters because implant surveillance and motion analysis are increasingly relevant as joint-preserving and reconstructive procedures expand and device longevity becomes a policy and cost consideration.
Key payers reviewed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and appropriate settings for the code, benchmarks for utilization and payment where available, and notes on coding considerations that affect billing and claims processing. The publication also outlines common sites of service and the clinical scenarios in which interpretation of tantalum-marker–assisted imaging is used.
What readers will learn: the clinical purpose of CPT code 0349T, typical use cases in postoperative and diagnostic workflows, which major payers cover this service, and where to look for policy language or reimbursement guidance. Data not available in the input is clearly identified where applicable.
Billing Code Overview
CPT code 0349T describes interpretation of two-dimensional imaging of the upper extremity — which may include the shoulder, elbow, and/or wrist — to analyze the motion, quality, and wear of an implant or prosthesis using previously placed tantalum markers. This service involves a provider reviewing and interpreting imaging sequences to assess implant positioning, kinematics, and evidence of wear or loosening.
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Service type: Diagnostic imaging interpretation for implant or prosthesis evaluation
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Typical site of service: Outpatient imaging center, hospital radiology department, or ambulatory surgical center where upper-extremity implant imaging is performed
Clinical & Coding Specifications
Clinical Context
A typical patient is a 65-year-old who previously underwent total shoulder arthroplasty with tantalum markers placed in peri-implant bone to enable motion analysis. The patient presents with progressive shoulder pain, decreased range of motion, and mechanical symptoms months to years after implantation. The orthopaedic surgeon orders dynamic, two-dimensional fluoroscopic or radiographic image acquisition with interpretation to analyze implant motion, wear patterns, component loosening, and relative kinematics of humeral and glenoid components using the previously placed tantalum markers.
The clinical workflow: the patient arrives to an outpatient radiology or orthopaedic imaging suite (often in an ambulatory surgery center or hospital radiology department). A technologist obtains motion images of the shoulder (and, if indicated, elbow or wrist) during standard active or passive motion sequences. Images are transferred to the interpreting provider (orthopaedic surgeon or musculoskeletal radiologist) who reviews marker-based kinematic sequences, documents implant motion/quality/wear, and generates a formal report. Results guide clinical decisions such as observation, physical therapy, targeted imaging, or revision surgery planning.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When only the physician interpretation is reported separate from technical image acquisition |
TC | Technical component | When only technical imaging services (equipment/technologist) are billed |
52 | Reduced services | When the study is performed but reduced in scope or effort |
53 | Discontinued procedure | When imaging acquisition is started but discontinued due to patient condition |
22 | Increased procedural services | When extraordinary work or complexity in interpretation is required beyond typical |
56 | Pre-operative services | When the provider billed for preoperative portion distinct from post-op care (facility-specific use) |
55 | Post-operative services | When the provider bills separate post-op follow-up services (facility-specific use) |
62 | Two surgeons | When two surgeons of different specialties share the interpretation responsibility |
80 | Assistant surgeon | When an assistant surgeon provides documented assistance relevant to the service |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | When an advanced practitioner assists and billing requires the AS modifier |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207X00000X | Orthopaedic Surgery | Primary specialty performing implant evaluation and interpretation |
| 207RR0500X | Orthopaedic Hand Surgery | Relevant when wrist or elbow prostheses or implant kinematics are evaluated |
| 207RC0000X | Orthopaedic Trauma | In cases of post-traumatic implants or hardware-related motion analysis |
| 207T00000X | Physical Medicine & Rehabilitation | May interpret functional implant motion in collaboration with surgeons |
| 2085P0200X | Diagnostic Radiology | Musculoskeletal radiologists interpret imaging sequences and provide reports |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M24.211 | Adhesive capsulitis of right shoulder | Stiffness and limited motion that may prompt implant kinematic assessment |
M24.212 | Adhesive capsulitis of left shoulder | See above for left shoulder |
M25.311 | Pain in right shoulder | Common presenting symptom prompting implant motion evaluation |
M25.312 | Pain in left shoulder | See above for left shoulder |
T84.010A | Infection and inflammatory reaction due to internal shoulder prosthesis, initial encounter | Infection may alter implant motion and require assessment |
T84.019A | Infection and inflammatory reaction due to internal prosthesis, unspecified shoulder, initial encounter | As above when laterality unspecified |
M96.611 | Other mechanical complication of internal joint prosthesis, right shoulder | Directly relevant for detecting wear, loosening, or mechanical failure |
M96.612 | Other mechanical complication of internal joint prosthesis, left shoulder | Same relevance for left-sided implants |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
0349T | Interpretation of 2-D images of the upper extremity with tantalum markers to analyze implant motion, quality, and wear | Primary code describing provider interpretation of marker-based kinematic imaging |
73030 | Radiologic examination, shoulder; complete, minimum of two views | Often performed before or alongside dynamic imaging to assess component position and osseous structures |
73070 | Radiologic examination, shoulder, arthroplasty; radiographic studies for prosthesis evaluation | Commonly used for standard imaging assessment of shoulder prosthesis |
73562 | Radiologic examination, humerus or elbow, with comparison, 2 views | May be used when elbow implants or proximal forearm relationships are evaluated |
76000 | Fluoroscopic guidance (separate procedure), imaging without contrast | If dynamic fluoroscopy is used to acquire motion sequences, technical fluoroscopy codes may apply |
99070 | Supplies and equipment beyond usual; e.g., specialized marker systems (facility-dependent) | Ancillary supply billing when special tantalum marker systems or image analysis software incur additional costs |