Mobility can become a continual challenge with age, and although the rotator cuff is not directly a factor in remaining mobile, it can affect range-of-motion activities and severely limit activity levels when this joint has become damaged. This may lead to mobility issues in the future as limited activity levels can lead to weight gain, cardiovascular problems and other issues that will go on to affect mobility.
In addition, damage to the rotator cuff, whether through injury or disease, can lead to severe pain and the potential for further damage to surrounding tissue with use as the body tries to compensate for the loss of motion. When damage has become severe, surgery may be considered to repair the problem.
Rotator Cuff Surgery as an Option
Surgery for rotator cuff injuries and disorders can correct a variety of problems, and the surgery itself often takes advantage of arthroscopic technology and techniques to minimize the invasiveness of the procedure. This type of surgery is used to re-attach tendons and tissues to bone in the shoulder that have been torn loose due to injury or exertion. In some situations, disease may also lead to the deterioration of connective tissue.
While hospitalization is typically not required after this type of procedure, age and overall health can play a part in recovery. Patients will also likely need to utilize a tiered approach to regaining full range-of-motion support in the affected shoulder through rehabilitation and targeted exercise.
Does Medicare Cover Rotator Cuff Surgery?
In terms of coverage by Medicare insurance, some people may be able to have the procedure completed with benefits when deemed medically necessary. Outpatient surgical procedures are covered by Medicare Part B, and these procedures need to be part of a treatment plan to heal or prevent a disease.
If range-of-motion is the only thing negatively affected, a surgical procedure may not be considered medically necessary in that the procedure only improves quality of life and is not required in order to continue living. With this stated, because of the potential for further damage to surrounding tissue, your doctor may be able to provide the documentation required to demonstrate the necessity of the surgery, especially when it is part of a more comprehensive treatment approach in the prevention of the spread of a disease like cancer.
Regardless of Medicare Part B and its coverage, you may be able to utilize Medicare Part A during rehabilitation if you require a temporary stay in a skilled nursing facility. These facilities may also provide additional care during the stay, most of which will be covered by Medicare Part A. For care and supplies after the surgery and after being released from a skilled nursing facility, you might be able to once again turn to Medicare Part B for insurance benefits.
Alternatives to Rotator Cuff Surgery
If you’re being affected by pain and limited range-of-motion in the shoulder, you may be able to find relief, even if temporarily, by working with an orthopedic specialist instead of seeking out a surgical solution. These individuals may also partner with physical therapists to develop treatment plans that prolong the need for surgery while providing pain relief and extending range-of-motion through strengthening exercises.
The goal is to allow other muscles in the affected area the chance to take over more of the heavy lifting operations to allow for healing of damaged tissue in the rotator cuff. In some cases, this approach alone may prevent the need for surgery, but this will depend on how much damage has already been done. Because of the nature of rotator cuff injuries and how tendons work with and attach to bone, severe injuries will require surgery at some point in order to provide for full recovery.
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