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An osteotomy of the radius, specifically at the distal third, is a surgical procedure aimed at correcting a deformity or realigning the bone structure of the radius. The term 'osteotomy' refers to the surgical cutting of bone, which is performed to address various deformities that may affect the functionality and alignment of the arm. The specific location of the osteotomy, in this case, the distal third of the radius, is chosen based on the nature and site of the deformity being treated. Different types of osteotomies can be employed, including transverse, wedge, sliding, right or left angle, V-osteotomy, and Z-osteotomy, each tailored to achieve the desired correction. Prior to the surgical intervention, the physician utilizes radiographic studies to accurately determine the optimal site for the bone cut, ensuring that the procedure is planned effectively to achieve the best possible outcome. The surgery involves making an incision over the radius, followed by careful dissection of the soft tissues to expose the bone. The periosteum, a layer of connective tissue surrounding the bone, is elevated to facilitate access. The actual osteotomy is performed using surgical instruments such as a drill, saw, or osteotome to create the necessary bone cut. In some cases, bone grafts may be inserted between the cut segments to promote healing and stability. To maintain proper alignment of the bone after the cut, various internal fixation devices, such as pins, screws, or plates, may be utilized. Alternatively, an external fixation device can be applied if deemed appropriate. This procedure is coded as CPT® Code 25350, specifically for osteotomy of the distal radius, while CPT® Code 25355 is designated for osteotomy of the middle or proximal radius.
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The osteotomy of the distal radius is indicated for various conditions that necessitate realignment or correction of the bone structure. These indications may include:
The procedure for performing an osteotomy of the distal radius involves several critical steps, each designed to ensure precision and effectiveness in correcting the bone alignment. The steps include:
After the osteotomy of the distal radius, post-procedure care is essential for optimal recovery. Patients are typically monitored for any signs of complications, such as infection or improper healing. Pain management strategies are implemented to ensure patient comfort during the recovery phase. The physician may recommend immobilization of the wrist and forearm using a splint or cast to protect the surgical site and maintain alignment as healing occurs. Rehabilitation exercises may be introduced gradually to restore range of motion and strength in the wrist, depending on the patient's progress and the surgeon's recommendations. Follow-up appointments are crucial to assess healing and make any necessary adjustments to the treatment plan.
| Short Descr | REVISION OF RADIUS | Medium Descr | OSTEOTOMY RADIUS DISTAL THIRD | Long Descr | Osteotomy, radius; distal third | 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 | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 161 - Other OR therapeutic procedures on bone |
| 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). | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | 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 | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| Pre-1990 | Added | Code added. |