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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 typically indicated in cases of osteomyelitis, an infection of the bone, or a bone abscess, which is a localized collection of pus within the bone. The sequestrectomy can be performed on various bones, including the clavicle, scapula, and humeral head to neck, with CPT® Code 23172 specifically referring to the procedure performed on the scapula. 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 cortical bone defect. After the necrotic tissue is excised, the incisions in the soft tissue and skin are closed, and a dressing is applied to protect the surgical site during the recovery period.
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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.
After the sequestrectomy, patients can expect a recovery period that may involve monitoring for signs of infection and managing pain. The surgical site will require proper care, including keeping the dressing clean and dry. Follow-up appointments will be necessary to assess healing and ensure that the bone is regenerating appropriately. Rehabilitation may also be recommended to restore function and strength in the affected area.
| Short Descr | REMOVE SHOULDER BLADE LESION | Medium Descr | SEQUESTRECTOMY SCAPULA | Long Descr | Sequestrectomy (eg, for osteomyelitis or bone abscess), scapula | 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) | 2 - Payment restriction for assistants at surgery does not apply 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) | 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) |
| 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). | 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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