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A sequestrectomy is a surgical procedure aimed at removing a sequestrum, which is a segment of necrotic (dead) bone that has detached from the surrounding healthy bone tissue. This procedure is specifically indicated for conditions such as osteomyelitis, an infection of the bone, or a bone abscess, which is a localized collection of pus within the bone. The procedure can be performed on various bones, including the clavicle, scapula, or the humeral head to neck. During the operation, an incision is made through the skin and soft tissue to access the affected area. If the periosteum, the layer of tissue covering the bone, is healthy, it is carefully lifted away from the sequestrum to allow for the excision of the necrotic bone. In cases where the periosteum is not viable, the surgeon may find that new bone, known as involucrum, has developed around the sequestrum. In such instances, the necrotic bone is removed while preserving the involucrum, which will aid in the healing process and contribute to the formation of new bone in the area of the defect. After the necrotic tissue is removed, the surgeon will close the incisions in the soft tissue and skin, followed by the application of a dressing to protect the surgical site.
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The sequestrectomy procedure is indicated for the following conditions:
The sequestrectomy procedure involves several critical steps to ensure the effective removal of the necrotic bone.
Post-procedure care involves monitoring the surgical site for signs of infection and ensuring proper healing. Patients may be advised on activity restrictions to allow for recovery. Follow-up appointments are typically scheduled to assess the healing process and to determine if further interventions are necessary. Pain management and wound care instructions will also be provided to support the recovery phase.
| Short Descr | REMOVE COLLAR BONE LESION | Medium Descr | SEQUESTRECTOMY CLAVICLE | Long Descr | Sequestrectomy (eg, for osteomyelitis or bone abscess), clavicle | 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) | 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 | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5B - Ambulatory procedures - musculoskeletal | MUE | 1 | CCS Clinical Classification | 161 - Other OR therapeutic procedures on 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) | 20702 | Add-on Code MPFS Status: Active Code APC N Manual preparation and insertion of drug-delivery device(s), intramedullary (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). | 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.) | 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 | 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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