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Epiphyseal arrest, specifically through the procedure of epiphysiodesis or stapling, is a surgical intervention aimed at addressing issues related to the growth of the bones in the forearm, particularly the distal radius and ulna. The term 'epiphyseal' refers to the epiphysis, which is the end part of a long bone, initially growing separately from the shaft. This area is commonly known as the growth plate, where bone growth occurs during childhood and adolescence. The procedure is indicated for patients experiencing an angulation deformity at the wrist or a discrepancy in bone length between the radius and ulna. During the surgery, an incision is made over the distal aspect of the radius and/or ulna, extending down to the wrist joint. Careful dissection of the soft tissues is performed to avoid damaging surrounding blood vessels and nerves. Once the distal radius and/or ulna are adequately exposed, various devices such as Blount staples, transphyseal screws, or a plate and screw device are utilized to strategically place within the epiphysis. This placement temporarily halts the growth of the bone. In cases where the procedure is aimed solely at correcting an angulation deformity, only a portion of the epiphysis is arrested, allowing the remaining portion to continue growing and thus correcting the deformity. Conversely, if the procedure is intended to address a bone length discrepancy, the entire epiphysis is arrested. It is important to note that CPT® Code 25450 should be used for epiphyseal arrest of either the radius or ulna alone, while CPT® Code 25455 is designated for procedures involving both the radius and ulna.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure of epiphyseal arrest by epiphysiodesis or stapling is indicated for specific conditions related to the growth and alignment of the bones in the forearm. The following are the primary indications for this surgical intervention:
The surgical procedure for epiphyseal arrest involves several critical steps to ensure proper execution and patient safety. The following outlines the procedural steps:
After the completion of the epiphyseal arrest procedure, specific post-operative care and considerations are 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. Rehabilitation may be necessary to restore function and strength in the wrist and forearm, depending on the extent of the procedure and the individual patient's needs. Follow-up appointments are crucial to assess the healing process and to determine if any further interventions are required. The expected recovery time may vary based on the patient's age, overall health, and adherence to post-operative care instructions.
| Short Descr | EPIPHYSL ARRST DSTL RDS&ULNA | Medium Descr | EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS&ULNA | Long Descr | Epiphyseal arrest by epiphysiodesis or stapling; distal 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) | 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) | 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). | RT | Right side (used to identify procedures performed on the right side of the body) |
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| 2025-01-01 | Changed | Short Description changed. |
| 2013-01-01 | Changed | Medium Descriptor changed. |
| Pre-1990 | Added | Code added. |
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