© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 23182 involves a partial excision of bone, specifically targeting the scapula to address osteomyelitis, which is an infection of the bone. This surgical intervention is also known by terms such as craterization, saucerization, or diaphysectomy. Craterization and saucerization refer to techniques that create a shallow depression in the bone surface by removing infected and necrotic bone, thereby facilitating drainage from the infected area. Diaphysectomy, on the other hand, pertains to the removal of the infected segment of the shaft of a long bone. The procedure begins with an incision through the skin and soft tissue over the osteomyelitis site, allowing access to the infected area. The surgeon meticulously resects any soft tissue sinus tracts and devitalized soft tissue to expose the necrotic and infected bone. A series of drill holes are then created in the affected bone, and the bone between these holes is excavated using an osteotome to form an oval window. The extent of bone removal is determined by the severity of the infection. Additionally, a curette may be employed to eliminate any devitalized tissue from the medullary canal. The debridement process continues until punctate bleeding is observed on the exposed bony surface, indicating healthy tissue. Following the complete removal of all infected and necrotic tissue, the surgical site is thoroughly irrigated with sterile saline or an antibiotic solution to reduce the risk of further infection. Finally, the wound is loosely closed, and a drain is placed to facilitate fluid drainage post-surgery.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 23182 is indicated for the treatment of osteomyelitis affecting the scapula. Osteomyelitis is characterized by the infection of bone tissue, which can lead to necrosis and significant complications if not addressed. The following conditions may warrant the performance of this procedure:
The procedure for CPT® Code 23182 involves several critical steps to ensure effective treatment of osteomyelitis in the scapula. The following outlines the procedural steps:
After the completion of the procedure, patients can expect a recovery period that may involve monitoring for signs of infection and managing any postoperative pain. The placement of a drain will help prevent fluid accumulation, and it is essential for the surgical site to be kept clean and dry. Follow-up appointments will be necessary to assess healing and ensure that the infection has been adequately addressed. The healthcare team will provide specific instructions regarding activity restrictions and wound care to promote optimal recovery.
| Short Descr | REMOVE SHOULDER BLADE LESION | Medium Descr | PARTIAL EXCISION BONE SCAPULA | Long Descr | Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), 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 | 142 - Partial excision 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). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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.) | 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 | 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) | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
|
Date
|
Action
|
Notes
|
|---|---|---|
| Pre-1990 | Added | Code added. |
Get instant expert-level medical coding assistance.