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The CPT® Code 21740 refers to the reconstructive surgical procedure performed to correct pectus excavatum or pectus carinatum, which are congenital deformities of the chest wall. Pectus excavatum, often described as a sunken or hollowed chest, occurs when the sternum is depressed inward, while pectus carinatum, also known as pigeon chest, is characterized by an outward protrusion of the sternum. This procedure is typically conducted under general anesthesia, ensuring that the patient is completely unconscious and free from pain during the operation. The surgical approach involves making an incision over the sternum, which is then deepened to expose the underlying structures, including the ribs. The surgeon carefully examines the ribs and may remove or repair any deformed bony or cartilaginous elements that contribute to the chest wall deformity. Once the ribs and sternum are properly aligned in their anatomical positions, internal fixation devices are utilized to stabilize the area, ensuring that the chest wall maintains its corrected shape. Finally, the incisions made during the procedure are meticulously closed to promote healing and minimize scarring.
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The procedure described by CPT® Code 21740 is indicated for patients presenting with the following conditions:
The surgical procedure for CPT® Code 21740 involves several critical steps to ensure effective correction of the chest wall deformity:
Post-procedure care for patients undergoing the reconstructive repair of pectus excavatum or carinatum includes monitoring for any signs of complications, such as infection or improper healing. Patients are typically advised on pain management strategies and may require follow-up visits to assess the healing process and the effectiveness of the surgical correction. Activity restrictions may be recommended to ensure proper recovery, and patients should be educated on signs that warrant immediate medical attention.
| Short Descr | RECONSTRUCTION OF STERNUM | Medium Descr | REPAIR PECTUS EXCAVATUM/CARINATUM OPEN | Long Descr | Reconstructive repair of pectus excavatum or carinatum; open | 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 | 164 - Other OR therapeutic procedures on musculoskeletal system |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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). | 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). | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| 2003-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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