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The CPT® Code 23146 refers to the excision or curettage of a bone cyst or benign tumor located in the clavicle or scapula, specifically when the procedure involves the use of an allograft. A bone cyst is defined as a fluid-filled space within the bone, which can vary in type. One common type is the unicameral or simple bone cyst, recognized as a benign lesion. Another type, the aneurysmal bone cyst, is characterized by vascular tissue that surrounds a blood-filled cystic lesion. Additionally, there are various benign bone tumors, including giant cell tumors, chondromyxoid fibromas, and enchondromas. The procedure begins with an incision made over the lesion site on the clavicle or scapula, followed by dissection of the soft tissues to expose the lesion. If a cystic lesion is identified, the bone is incised to create a window, allowing for the aspiration of fluid, which is then sent for laboratory analysis. The lining of the cystic cavity is removed using a curette. In cases where benign tumors are present, the lesion is excised along with a margin of healthy bone. Following the excision or curettage, the defect created is filled with donor bone (allograft), which is essential for the healing process and structural support of the affected area.
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The procedure described by CPT® Code 23146 is indicated for the treatment of specific conditions related to bone cysts or benign tumors in the clavicle or scapula. The following are the primary indications for performing this procedure:
The procedure for CPT® Code 23146 involves several critical steps to ensure the effective excision or curettage of the lesion. The following outlines the procedural steps:
Post-procedure care following the excision or curettage of a bone cyst or benign tumor involves monitoring the surgical site for signs of infection and ensuring proper healing. Patients may be advised to limit physical activity to allow for adequate recovery. Follow-up appointments are typically scheduled to assess the healing process and to evaluate the effectiveness of the allograft in supporting bone regeneration. Any additional care instructions will be provided based on the individual patient's needs and the specifics of the procedure performed.
| Short Descr | REMOVAL OF BONE LESION | Medium Descr | EXC/CURTG BONE CST/B9 TUM CLAV/SCAPULA W/ALGRFT | Long Descr | Excision or curettage of bone cyst or benign tumor of clavicle or scapula; with allograft | 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) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - 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 | Hospital Part B services paid through a comprehensive APC | 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 | 142 - Partial excision bone |
| 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). | 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. | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 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) |
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| Pre-1990 | Added | Code added. |
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