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Official Description

Radical resection of tumor; ischial tuberosity and greater trochanter of femur

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Radical resection of a tumor, specifically involving the ischial tuberosity and greater trochanter of the femur, 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. Once the incision is made, the surgeon meticulously dissects the overlying tissue to expose the tumor. The radical resection entails the complete removal of all bone and cartilage that is involved with the tumor, ensuring that the ischial tuberosity and greater trochanter of the femur are thoroughly addressed. The tumor is excised en bloc, which means it is removed in one piece along with a wide margin of surrounding healthy tissue to minimize the risk of residual tumor cells. This comprehensive approach includes the excision of all affected soft tissues, which may encompass muscles, tendons, fat, blood vessels, lymph vessels, nerves, and any tissues surrounding the joints. To confirm that all tumor margins are clear of malignancy, a separately reportable frozen section may be performed during the procedure. If any margins are found to contain tumor cells, additional tissue will be excised until all margins are confirmed to be free of malignancy. Post-surgery, drains may be placed as necessary to manage fluid accumulation, and the surgical wound can be closed in layers, or additional reconstructive procedures may be performed as needed.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The radical resection of a tumor involving the ischial tuberosity and greater trochanter of the femur 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 some cases, benign tumors that pose a risk of complications or have the potential for malignant transformation may also necessitate radical resection.
  • Indeterminate Tumors Tumors of indeterminate nature, where the characteristics of the tumor are unclear, may require radical resection to ensure that any potential malignancy is addressed.

2. Procedure

The procedure for radical resection of the tumor follows several critical steps:

  • Step 1: Incision A skin incision is made directly over the site of the bone tumor. Alternatively, a skin flap may be created and elevated to provide adequate access to the underlying structures.
  • Step 2: Dissection The surgeon carefully dissects the overlying tissue to expose the tumor, ensuring that surrounding structures are preserved as much as possible during this process.
  • Step 3: Tumor Resection All bone and cartilage that are involved with the tumor in the ischial tuberosity and greater trochanter of the femur are resected. The tumor is removed en bloc, which includes a wide margin of surrounding healthy tissue to ensure complete excision.
  • Step 4: Soft Tissue Excision The radical resection encompasses the excision of all affected soft tissues, which may include muscles, tendons, fat, blood vessels, lymph vessels, nerves, and any tissues surrounding the joints, to ensure that no tumor cells remain.
  • Step 5: Frozen Section A separately reportable frozen section may be performed during the procedure to assess the margins of the excised tissue. If any margins show evidence of malignancy, additional tissue will be removed until all margins are confirmed to be free of tumor cells.
  • Step 6: Drain Placement Drains may be placed as needed to manage any fluid accumulation post-surgery, which helps in preventing complications such as seromas or hematomas.
  • Step 7: Wound Closure 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

After the radical resection procedure, patients may require monitoring for complications such as infection or fluid accumulation. The expected recovery process will vary based on the extent of the surgery and the patient's overall health. Patients may need to follow specific post-operative care instructions, including wound care and activity restrictions, to promote healing. Follow-up appointments will be necessary to assess recovery and to discuss any further treatment options, such as rehabilitation or additional therapies, depending on the pathology results and the patient's condition.

Short Descr RSECT HIP TUM INCL FEMUR
Medium Descr RAD RESCT TUMOR ISCHIAL TUBEROSITY&GRT TRCHNTR
Long Descr Radical resection of tumor; ischial tuberosity and greater trochanter of femur
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) 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
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.
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.
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.)
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)
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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