© Copyright 2025 American Medical Association. All rights reserved.
Percutaneous skeletal fixation is a minimally invasive surgical procedure utilized to treat fractures of the distal radius, which is the lower part of the outer bone of the forearm located near the wrist. This procedure is also applicable in cases of epiphyseal separation, a condition affecting the growth plate at the end of a long bone. The epiphysis is crucial for bone growth and development, and its separation can lead to complications if not properly addressed. Prior to the fixation, the fractured bone or separated epiphysis must be realigned, a process known as reduction. This may involve the application of traction and manipulation techniques to ensure that the bone fragments are positioned correctly. Once the fracture is aligned, the physician employs Kirschner wires, commonly referred to as K-wires or pins, to stabilize the fracture. These K-wires are thin, rigid, and sharp stainless steel pins that are inserted into the bone through the skin using a specialized drill, which is characteristic of percutaneous techniques. The placement of K-wires involves driving them through the radius across the fracture site and into the opposite bone, effectively holding the fractured pieces together. After insertion, the K-wires are typically cut just below the skin surface, and the arm is then immobilized to facilitate healing. Depending on the specific case, the K-wires may be removed after a few weeks or may remain in place for definitive fixation, particularly in instances involving small fracture fragments. This procedure is essential for ensuring proper healing and restoring function to the wrist and forearm.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure of percutaneous skeletal fixation of the distal radial fracture or epiphyseal separation is indicated for the following conditions:
The procedure involves several critical steps to ensure effective stabilization of the fracture or separation:
After the percutaneous skeletal fixation procedure, the patient will typically require a period of immobilization to allow for proper healing of the fracture or epiphyseal separation. The K-wires may remain in place for several weeks, depending on the specific case and the physician's assessment of healing progress. Follow-up appointments will be necessary to monitor the healing process, and the K-wires may be removed once adequate healing has occurred. It is important for the patient to adhere to any post-operative care instructions provided by the physician to ensure a successful recovery.
| Short Descr | PERQ SKEL FIXJ DSTL RDL FX | Medium Descr | PERQ SKEL FIXJ DISTAL RADIAL FX/EPIPHYSL SEP | Long Descr | Percutaneous skeletal fixation of distal radial fracture or epiphyseal separation | 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 | 145 - Treatment, fracture or dislocation of radius and ulna |
| 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) | 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). | 54 | Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number. | 55 | Postoperative management only: when 1 physician or other qualified health care professional performed the postoperative management and another performed the surgical procedure, the postoperative component may be identified by adding modifier 55 to the usual procedure number. | 57 | Decision for surgery: an evaluation and management service that resulted in the initial decision to perform the surgery may be identified by adding modifier 57 to the appropriate level of e/m service. | 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). | 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 | F9 | Right hand, fifth digit | 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 | 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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| 2025-01-01 | Changed | Short Description changed. |
| 2007-01-01 | Added | First appearance in code book in 2007. |
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