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The CPT® Code 21820 refers to the closed treatment of a sternum fracture, which is a type of injury involving the breastbone, located in the center of the chest. In this procedure, the fracture is assessed and determined to be stable and non-displaced, meaning that the bone fragments have not moved out of their normal alignment. This assessment is typically confirmed through the use of X-rays, which are reported separately to document the condition of the fracture. During the closed treatment process, no external devices such as braces or splints are applied to stabilize the fracture. Instead, the focus is on managing the patient's activity level, with recommendations for reduced physical activity to facilitate healing. This approach is generally aimed at minimizing discomfort and promoting recovery without the need for surgical intervention or invasive procedures.
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The closed treatment of a sternum fracture, as indicated by CPT® Code 21820, is performed under specific circumstances where the fracture is assessed to be stable and non-displaced. The following conditions may warrant this procedure:
The closed treatment of a sternum fracture involves several key procedural steps that ensure proper management of the injury. Each step is crucial for the effective treatment and recovery of the patient.
After the closed treatment of a sternum fracture, the patient is typically monitored for any changes in symptoms or complications. Since no braces or splints are used, the focus is on managing pain and ensuring that the patient adheres to the recommended activity restrictions. Follow-up appointments may be scheduled to reassess the fracture's healing progress through additional imaging if necessary. Patients are advised to report any new or worsening symptoms, such as increased pain or difficulty breathing, as these may indicate complications that require further evaluation.
| Short Descr | TREAT STERNUM FRACTURE | Medium Descr | CLOSED TREATMENT STERNUM FRACTURE | Long Descr | Closed treatment of sternum fracture | 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) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Multiple Reduction Applies | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 148 - Other fracture and dislocation 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). | 54 | Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number. | 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. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| Pre-1990 | Added | Code added. |
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