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Osteotomy of the femoral neck is a surgical procedure aimed at correcting deformities or abnormalities in the femoral neck, which may be short, long, or malformed. This procedure is typically indicated when conservative treatments have failed to alleviate symptoms or when structural correction is necessary to improve hip function. The surgery involves making a skin incision over the lateral aspect of the hip joint, allowing access to the femur. Once the soft tissues are carefully dissected, the femur is exposed, and the femoral head is dislocated from the acetabulum to facilitate the osteotomy. The surgeon then marks the planned osteotomy sites and performs a series of precise cuts in the femoral neck. These cuts enable the surgeon to shorten, lengthen, or reconfigure the bone as needed. Wedges created from the cut bone are strategically placed at the osteotomy sites to ensure that the proper angles are maintained in the reconfigured bone. To secure the new position and shape of the bone, internal fixation devices such as pins, screws, or wires may be utilized. After the osteotomy is completed, the femoral head is repositioned into the acetabulum, and the range of motion in the hip is assessed before the incisions are closed in layers, ensuring proper healing and recovery.
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Osteotomy of the femoral neck is performed for several specific indications, which include:
The procedure for osteotomy of the femoral neck involves several critical steps, which are detailed as follows:
After the osteotomy of the femoral neck, patients can expect a recovery period that may involve pain management, physical therapy, and gradual return to normal activities. Post-operative care is crucial to monitor for any complications and to ensure proper healing of the surgical site. Patients will typically be advised on weight-bearing restrictions and may require assistive devices during the initial recovery phase. Follow-up appointments will be necessary to assess the healing process and to evaluate the success of the procedure in restoring hip function.
| Short Descr | INCISION OF NECK OF FEMUR | Medium Descr | OSTEOTOMY FEMORAL NECK SEPARATE PROCEDURE | Long Descr | Osteotomy, femoral neck (separate procedure) | 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 | 161 - Other OR therapeutic procedures on bone |
| 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). | 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. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure 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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