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A radical resection of the sternum, commonly referred to as the breast bone, is a surgical procedure primarily performed to address malignant tumors located in this area. These tumors are classified as primary malignant bone tumors, which are relatively rare, and may include types such as osteosarcoma, chondrosarcoma, myeloma, or malignant lymphomas. The procedure involves making a surgical incision over the sternum and upper chest to gain access to the underlying structures. During the operation, the surgeon meticulously dissects the soft tissues and elevates the pectoral muscles to expose the sternum and rib cage adequately. Once the tumor is identified, the surgeon maps it out to determine the appropriate margins for removal, ensuring that all cancerous tissue is excised. The use of specialized saws and surgical implements allows for the division of the sternum and its complete detachment from surrounding soft tissues, along with the planned margin of ribs. This extensive removal results in a significant defect in the chest wall, necessitating reconstruction to safeguard the lungs and maintain structural integrity. The reconstruction is typically performed immediately following the resection and may involve various materials, such as an iliac crest autograft with internal fixation devices, polypropylene mesh combined with a layer of methylmethacrylate, or an inner acellular dermal matrix secured with a titanium plate and covered by musculocutaneous soft tissues.
© Copyright 2025 Coding Ahead. All rights reserved.
The radical resection of the sternum is indicated for the treatment of malignant tumors located in the sternum area. These tumors may present with various symptoms and conditions that necessitate surgical intervention. The specific indications for this procedure include:
The procedure for a radical resection of the sternum involves several critical steps to ensure the complete removal of the tumor and surrounding tissues. The steps are as follows:
Post-procedure care following a radical resection of the sternum is critical for patient recovery and includes monitoring for complications, managing pain, and ensuring proper healing of the surgical site. Patients may require additional support for respiratory function due to the significant chest wall defect. Follow-up appointments are essential to assess the integrity of the reconstruction and to monitor for any signs of recurrence of the malignancy. Rehabilitation may also be necessary to restore strength and mobility in the chest area, and patients should be educated on signs of infection or other complications that may arise during the recovery process.
| Short Descr | RADICAL RESECTION STERNUM | Medium Descr | RADICAL RESECTION STERNUM | Long Descr | Radical resection of sternum | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 142 - Partial excision bone |
This is a primary code that can be used with these additional add-on codes.
| 20700 | Add-on Code MPFS Status: Active Code APC N ASC N1 Manual preparation and insertion of drug-delivery device(s), deep (eg, subfascial) (List separately in addition to code for primary procedure) |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| 2025-01-01 | Changed | Short and Long Descriptions changed. |
| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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