Coding Ahead
CasePilot
Medical Coding Assistant
Case2Code
Search and Code Lookup Tool
RedactPHI
HIPAA-Compliant PHI Redaction
DetectICD10CM
ICD-10-CM Code Detection
Log in Register free account
1 code page views remaining. Guest accounts are limited to 1 page view. Register free account to get 5 more views.
Log in Register free account

Official Description

Radical resection of tumor; ilium, including acetabulum, both pubic rami, or ischium and acetabulum

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Radical resection of a tumor in the ilium, including the acetabulum, both pubic rami, or ischium and acetabulum, is a surgical procedure primarily indicated for the removal of malignant neoplasms. However, it may also be necessary for benign tumors or tumors of indeterminate nature. The procedure begins with the creation of a skin incision directly over the tumor site, or alternatively, a skin flap may be elevated to provide access. The surgeon meticulously dissects the overlying tissue to expose the tumor, ensuring that all affected bone and cartilage in the specified areas are resected. This comprehensive approach involves the removal of the tumor en bloc, which means the tumor is excised along with a wide margin of surrounding healthy tissue to ensure complete removal. The radical resection process also encompasses the excision of all involved soft tissues, which can include muscles, tendons, fat, blood vessels, lymph vessels, nerves, and any tissues surrounding the joints. To confirm that all margins are free of tumor cells, a separately reportable frozen section may be performed during the procedure. If any margins are found to contain malignancy, additional tissue will be excised until clear margins are achieved. Post-surgery, drains may be placed as necessary, and the surgical wound can be closed in layers, or additional reconstructive procedures may be performed as required.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The radical resection of a tumor in the ilium, including the acetabulum, both pubic rami, or ischium and acetabulum, is indicated for the following conditions:

  • Malignant Neoplasm The primary indication for this procedure is the presence of a malignant tumor that requires complete removal to prevent further spread and to manage the disease effectively.
  • Benign Tumors In certain cases, benign tumors that may pose a risk of complications or have the potential for malignant transformation may also necessitate radical resection.
  • Tumors of Indeterminate Nature Tumors that cannot be definitively classified as benign or malignant may require radical resection to ensure comprehensive evaluation and treatment.

2. Procedure

The procedure for radical resection of the tumor involves several critical steps, each designed to ensure the complete removal of the tumor and surrounding affected tissues.

  • Step 1: Incision The surgical process begins with the creation of a skin incision over the site of the bone tumor. In some cases, a skin flap may be elevated to provide better access to the underlying structures.
  • Step 2: Dissection Following the incision, the surgeon carefully dissects the overlying tissue to expose the tumor. This step is crucial for visualizing the extent of the tumor and its involvement with surrounding structures.
  • Step 3: Tumor Resection The tumor, along with all bone and cartilage that shows involvement, is resected. This includes the ilium, both pubic rami, or the ischium and acetabulum, ensuring that a wide margin of healthy tissue is included in the excision.
  • Step 4: Soft Tissue Excision In addition to the bone, all involved soft tissues are excised. This may encompass muscles, tendons, fat, blood vessels, lymph vessels, nerves, and any tissues surrounding the joints that may harbor tumor cells.
  • Step 5: Frozen Section Analysis A separately reportable frozen section may be performed during the procedure to assess the margins of the excised tissue. This analysis is critical to confirm that all margins are free of tumor cells.
  • Step 6: Additional Resection if Necessary If the frozen section indicates the presence of malignancy at the margins, additional tissue will be removed until clear margins are achieved, ensuring complete tumor excision.
  • Step 7: Drain Placement After the tumor and surrounding tissues have been removed, drains may be placed as needed to prevent fluid accumulation at the surgical site.
  • Step 8: Wound Closure Finally, the surgical wound may be closed in layers, or if necessary, separately reportable reconstructive procedures may be performed to restore the area.

3. Post-Procedure

Post-procedure care following a radical resection of the tumor includes monitoring for any complications, managing pain, and ensuring proper wound healing. Patients may require follow-up imaging or assessments to evaluate the success of the resection and to check for any signs of recurrence. The placement of drains, if utilized, will be monitored and managed appropriately. Recovery may vary based on the extent of the surgery and the patient's overall health, and rehabilitation may be necessary to restore function in the affected area.

Short Descr RESECT HIP TUM INCL ACETABUL
Medium Descr RAD RESCT TUMOR ILIUM ACETABULUM BOTH PUBIC
Long Descr Radical resection of tumor; ilium, including acetabulum, both pubic rami, or ischium and acetabulum
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) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
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) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Inpatient Procedures, not paid under OPPS
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P3D - Major procedure, orthopedic - other
MUE 1
CCS Clinical Classification 142 - Partial excision bone

This is a primary code that can be used with these additional add-on codes.

20932 Add-on Code MPFS Status: Active Code APC N ASC N1 Allograft, includes templating, cutting, placement and internal fixation, when performed; osteoarticular, including articular surface and contiguous bone (List separately in addition to code for primary procedure)
20933 Add-on Code MPFS Status: Active Code APC N ASC N1 Allograft, includes templating, cutting, placement and internal fixation, when performed; hemicortical intercalary, partial (ie, hemicylindrical) (List separately in addition to code for primary procedure)
20934 Add-on Code MPFS Status: Active Code APC N ASC N1 Allograft, includes templating, cutting, placement and internal fixation, when performed; intercalary, complete (ie, cylindrical) (List separately in addition to code for primary procedure)
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.
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
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.
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
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
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)
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
RT Right side (used to identify procedures performed on the right side of the body)
Date
Action
Notes
2010-01-01 Changed Code description changed.
Pre-1990 Added Code added.
Code
Description
Code
Description
Code
Description
Code
Description
CasePilot

Get instant expert-level medical coding assistance.

Ask about:
CPT Codes Guidelines Modifiers Crosswalks NCCI Edits Compliance Medicare Coverage
Example: "What is CPT code 99213?" or "Guidelines for E/M services"