© Copyright 2025 American Medical Association. All rights reserved.
Decompression fasciotomy is a surgical procedure aimed at alleviating the pressure within muscle compartments, specifically in the forearm and/or wrist, to treat a condition known as compartment syndrome. Compartment syndrome occurs when swelling within a muscle compartment leads to increased pressure, which can compress blood vessels and nerves, potentially resulting in irreversible damage to the muscles and nerves if not addressed promptly. The muscle compartments in the forearm are divided into two main areas: the flexor compartment, which is located on the volar (anterior) side, and the extensor compartment, located on the dorsal (posterior) side. This procedure involves the surgical release of both compartments to restore normal blood flow and nerve function. The fascia, a dense connective tissue that encases the muscle compartments, does not stretch, so when swelling occurs, it can lead to significant complications. The decompression is performed without the removal of any nonviable muscle or nerve tissue, distinguishing it from other procedures that may involve debridement. The surgical approach typically includes incisions that allow access to both compartments, ensuring that adequate decompression is achieved to prevent further complications and promote recovery.
© Copyright 2025 Coding Ahead. All rights reserved.
Decompression fasciotomy is indicated for the treatment of compartment syndrome, which can arise from various conditions that lead to increased pressure within the muscle compartments of the forearm and wrist. The following are specific indications for this procedure:
The procedure for decompression fasciotomy involves several critical steps to ensure effective release of pressure within both the flexor and extensor compartments:
After the decompression fasciotomy, the patient will require careful monitoring and management. The incisions are left open to allow for swelling to decrease, and they are covered with a sterile dressing to protect the surgical site. The patient is typically observed for signs of improved circulation and nerve function. Once the swelling has subsided, usually within 24 to 72 hours, the patient will be scheduled for a follow-up procedure to close the wounds. Post-operative care may include pain management, physical therapy, and monitoring for any complications such as infection or delayed healing. It is essential to follow the surgeon's instructions regarding activity restrictions and rehabilitation to ensure optimal recovery.
| Short Descr | DECOMPRESS FOREARM 2 SPACES | Medium Descr | DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR W/O DB | Long Descr | Decompression fasciotomy, forearm and/or wrist, flexor AND extensor compartment; without debridement of nonviable muscle and/or nerve | 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 | 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 | 160 - Other therapeutic procedures on muscles and tendons |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 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). | 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 | GW | Service not related to the hospice patient's terminal condition | 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
|
|---|---|---|
| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2002-01-01 | Added | First appearance in code book in 2002. |
Get instant expert-level medical coding assistance.