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Arthrodesis, commonly known as fusion, is a surgical procedure aimed at alleviating severe elbow pain, particularly when conservative treatments such as medication or physical therapy have failed. This procedure is often indicated for patients suffering from debilitating arthritis or those who have experienced significant trauma to the elbow joint. The surgery involves creating a stable union between the bones of the elbow joint, which can help restore function and reduce pain. During the procedure, a skin incision is made on the posterior side of the elbow, allowing access to the joint. The surgeon retracts the tendons and ligaments to expose the joint surfaces, where the articular cartilage is meticulously removed. This preparation is crucial for the successful fusion of the bones. The elbow is then positioned at a 90-degree angle, ensuring proper alignment of the radius, ulna, and humerus. Bone grafts, which may be harvested locally or from a separate incision, are used to fill the joint space and promote healing. The fixation of the bones can be achieved through various methods, including plate and screw fixation or external fixation devices, depending on the specific needs of the patient. The procedure concludes with the closure of the incisions, and if plate and screw fixation is utilized, the arm is immobilized in a cast or splint to support the healing process.
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The procedure of arthrodesis of the elbow joint is indicated for specific conditions that lead to severe pain and dysfunction. The following are the primary indications for performing this surgical intervention:
The arthrodesis procedure involves several critical steps to ensure successful fusion of the elbow joint. The following outlines the procedural steps:
After the arthrodesis procedure, patients can expect specific post-operative care and recovery considerations. The immobilization of the arm in a cast or splint is crucial to ensure that the bones remain stable during the healing process. Patients will typically be monitored for signs of infection, proper healing, and any complications that may arise. Pain management strategies will be implemented to help alleviate discomfort during recovery. Physical therapy may be recommended after an appropriate healing period to help restore function and strength to the elbow joint. The overall recovery time can vary based on individual patient factors, but adherence to post-operative instructions is essential for optimal outcomes.
| Short Descr | FUSION OF ELBOW JOINT | Medium Descr | ARTHRODESIS ELBOW JOINT LOCAL | Long Descr | Arthrodesis, elbow joint; local | 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) | 1 - Co-surgeons could be paid, though supporting documentation is required... | 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 | 162 - Other OR therapeutic procedures on joints |
This is a primary code that can be used with these additional add-on codes.
| 20705 | Add-on Code MPFS Status: Active Code APC N Removal of drug-delivery device(s), intra-articular (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. | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code 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) |
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| Pre-1990 | Added | Code added. |
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