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Open treatment of a carpal scaphoid fracture, also known as a navicular fracture, involves a surgical procedure aimed at realigning and stabilizing the scaphoid bone, which is one of the eight small carpal bones in the wrist. The scaphoid bone is located at the base of the thumb and is the most frequently fractured bone in the wrist, often due to trauma such as falling onto an outstretched hand. The procedure begins with an incision made in the palm of the hand, utilizing a volar approach to access the fracture site. Once the fracture is located, it is carefully cleaned of any debris, and the bone fragments are repositioned to restore proper alignment. Internal fixation is then applied to maintain the alignment of the fracture during the healing process. This typically involves the use of screws, which are inserted to secure the fracture fragments together. The surgical technique ensures that the scaphoid bone is stabilized, promoting optimal healing and function of the wrist post-surgery.
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The open treatment of a carpal scaphoid fracture is indicated for patients who present with a fracture of the scaphoid bone, which may be characterized by specific symptoms and conditions. The following are the primary indications for this procedure:
The procedure for the open treatment of a carpal scaphoid fracture involves several critical steps to ensure successful realignment and stabilization of the bone. The following outlines the procedural steps:
After the open treatment of a carpal scaphoid fracture, patients typically require a period of immobilization to allow for proper healing of the bone. This may involve the use of a cast or splint to restrict movement of the wrist and thumb. Patients are monitored for signs of complications, such as infection or improper healing. Follow-up appointments are essential to assess the healing process through imaging studies, and rehabilitation may be recommended to restore function and strength to the wrist once healing is confirmed. The expected recovery time can vary based on the severity of the fracture and the individual patient's healing response.
| Short Descr | OPTX CARPL SCPHD FX INT FIXJ | Medium Descr | OPEN TX CARPAL SCAPHOID NAVICULAR FX W/INT FIXJ | Long Descr | Open treatment of carpal scaphoid (navicular) fracture, includes internal fixation, when performed | 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) | P5B - Ambulatory procedures - musculoskeletal | MUE | 1 | CCS Clinical Classification | 148 - Other fracture and dislocation procedure |
| LT | Left side (used to identify procedures performed on the left side of the body) | 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. | 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). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | F8 | Right hand, fourth digit | GC | This service has been performed in part by a resident under the direction of a teaching physician | RT | Right side (used to identify procedures performed on the right side of the body) | SG | Ambulatory surgical center (asc) facility service | 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 and Medium Descriptions changed. |
| 2008-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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