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Radical resection of a tumor, specifically the innominate bone, is a surgical procedure primarily indicated for the removal of malignant neoplasms. However, it may also be necessary for benign tumors or those 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. Once the incision is made, the surgeon meticulously dissects the overlying tissue to expose the tumor. The entire innominate bone is then resected, which involves removing the tumor en bloc, meaning the tumor is excised along with a wide margin of surrounding healthy tissue to ensure complete removal. This radical approach is crucial as it 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 that may be affected by the tumor. To confirm that the surgical 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 all margins are confirmed to be clear of tumor cells. Post-surgery, drains may be placed as necessary to manage fluid accumulation, and the surgical wound is typically closed in layers. In some cases, separately reportable reconstructive procedures may be performed to restore the area after the radical resection.
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Radical resection of the innominate bone is indicated for the following conditions:
The procedure for radical resection of the innominate bone involves several critical steps:
Post-procedure care following a radical resection of the innominate bone involves monitoring for complications and ensuring proper recovery. Patients may require pain management and close observation for any signs of infection or complications related to the surgical site. The placement of drains will be monitored, and they may be removed once fluid accumulation is deemed minimal. Rehabilitation may be necessary to restore function and mobility, particularly if significant soft tissue or bone structures were involved in the resection. Follow-up appointments will be essential to assess healing and to conduct any necessary further evaluations, including imaging studies to ensure that there is no recurrence of the tumor.
| Short Descr | RESECT HIP TUM W/INNOM BONE | Medium Descr | RADICAL RESCTION TUMOR INNOMINATE BONE TOTAL | Long Descr | Radical resection of tumor; innominate bone, total | 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) |
| 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). | 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) | RT | Right side (used to identify procedures performed on the right side of the body) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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