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Official Description

Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); radius

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 25151 involves a partial excision of bone, specifically targeting the radius, 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, entails 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 affected area. During the operation, any associated soft tissue sinus tracts and devitalized soft tissue are excised to ensure a clean surgical field. The surgeon then exposes the necrotic and infected bone, employing a series of drill holes to delineate the area of bone that needs to be removed. The bone between these holes is excavated using an osteotome, and the extent of bone excised is determined by the severity of the infection. A curette may be utilized to clear out any remaining devitalized tissue from the medullary canal. The debridement process continues until healthy bone is reached, indicated by the presence of punctate bleeding on the exposed surface. Following the 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 any necessary postoperative drainage.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 25151 is indicated for the treatment of osteomyelitis, which is a serious bone infection that can lead to significant morbidity if not addressed promptly. The following conditions may warrant this surgical intervention:

  • Osteomyelitis of the Radius - This procedure is specifically performed to manage infections localized to the radius, where the infection may have resulted in necrotic bone tissue that requires removal.

2. Procedure

The procedure for CPT® Code 25151 involves several critical steps to ensure effective treatment of osteomyelitis:

  • Step 1: Incision and Exposure - The surgeon begins by making an incision in the skin over the site of the osteomyelitis. This incision is carefully extended through the soft tissue layers to expose the underlying bone affected by the infection.
  • Step 2: Resection of Soft Tissue - Once the bone is exposed, any soft tissue sinus tracts and devitalized soft tissue surrounding the infected area are resected. This step is crucial to eliminate any potential sources of infection and to prepare the site for further intervention.
  • Step 3: Bone Exposure - The area of necrotic and infected bone is then fully exposed, allowing the surgeon to assess the extent of the infection and determine the necessary amount of bone to be excised.
  • Step 4: Drilling and Excavation - A series of drill holes are made in the infected bone. The bone between these drill holes is excavated using an osteotome, which helps to create an oval window in the bone. The extent of bone removal is dictated by the severity of the infection.
  • Step 5: Curettage - A curette may be employed to remove any remaining devitalized tissue from the medullary canal, ensuring that all infected material is cleared from the surgical site.
  • Step 6: Hemostasis and Irrigation - The debridement continues until punctate bleeding is observed on the exposed bony surface, indicating that healthy bone has been reached. The surgical area is then copiously irrigated with sterile saline or an antibiotic solution to minimize the risk of postoperative infection.
  • Step 7: Wound Closure - Finally, the surgical wound is loosely closed, and a drain is placed to allow for any necessary drainage of fluids postoperatively.

3. Post-Procedure

After the completion of the procedure, patients are typically monitored for any signs of complications, such as infection or excessive bleeding. The surgical site may require regular dressing changes, and the drain will be monitored for output. Patients may also be prescribed antibiotics to further prevent infection. Recovery time can vary based on the extent of the surgery and the patient's overall health, but follow-up appointments will be necessary to assess healing and ensure that the infection has been adequately addressed.

Short Descr PARTIAL REMOVAL OF RADIUS
Medium Descr PARTIAL EXCISION BONE RADIUS
Long Descr Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); radius
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) 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)
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)
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).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
F1 Left hand, second digit
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)
SG Ambulatory surgical center (asc) facility service
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
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