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An osteotomy of the radius and ulna is a surgical procedure aimed at correcting deformities or realigning the bones in the forearm. This procedure may involve either the ulna alone or both the radius and ulna, depending on the specific deformity being addressed. The choice of the osteotomy type and its location is determined by the nature and site of the deformity. Various osteotomy techniques can be employed, including transverse, wedge, sliding, right or left angle, V-osteotomy, and Z-osteotomy. Prior to the surgical intervention, the physician utilizes radiographic studies to accurately identify the precise locations for the bone cuts, ensuring optimal alignment and correction. The surgical process begins with an incision made over the deformity site in the forearm, followed by dissection of the soft tissues to expose the ulna. The periosteum, a layer of connective tissue surrounding the bone, is then elevated to facilitate access. Using specialized instruments such as drills, saws, and osteotomes, the bone is cut according to the predetermined configuration. If necessary, bone grafts may be placed between the cut segments to promote healing and stability. To secure the bone fragments in their correct anatomical positions, various fixation methods may be employed, including pins, screws, or plates. In some cases, an external fixation device may also be utilized. This comprehensive approach ensures that both the radius and ulna are properly aligned and stabilized following the osteotomy.
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The osteotomy of the radius and ulna is indicated for various conditions that necessitate the correction of bone deformities or misalignments. The following are specific indications for this procedure:
The procedure for performing an osteotomy of the radius and ulna involves several critical steps, each designed to ensure the successful correction of the deformity:
After the osteotomy procedure, patients typically require careful monitoring and follow-up care to ensure proper healing and recovery. Post-procedure care may include pain management, immobilization of the forearm, and physical therapy to restore function. The expected recovery time can vary based on the individual patient's condition and the extent of the surgery. Regular follow-up appointments are essential to assess the healing process and to make any necessary adjustments to the treatment plan.
| Short Descr | REVISE RADIUS & ULNA | Medium Descr | OSTEOTOMY RADIUS & ULNA | Long Descr | Osteotomy; radius AND ulna | 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) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 161 - Other OR therapeutic procedures on bone |
| 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. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 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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