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An osteotomy of the femoral shaft or supracondylar region is a surgical procedure aimed at correcting a deformity or realigning the bone structure of the femur. This procedure is particularly relevant in cases where the alignment of the femur has been compromised due to various conditions, such as congenital deformities, trauma, or degenerative diseases. The term 'osteotomy' refers to the surgical cutting of bone, and in this context, it specifically pertains to the femur, which is the long bone in the thigh. The specific location of the osteotomy—whether at the shaft or the supracondylar region—depends on the nature and site of the deformity being addressed. Surgeons may employ different types of osteotomies, including transverse, wedge, sliding, right or left angle, V-osteotomy, and Z-osteotomy, each chosen based on the specific requirements of the deformity. Prior to the surgical intervention, the physician utilizes radiographic studies to accurately determine the optimal site for the bone cut, ensuring that the procedure will achieve the desired alignment and correction. The surgical process involves making an incision over the targeted area of the femur, followed by careful dissection of the surrounding soft tissues to expose the bone. The periosteum, a dense layer of connective tissue surrounding the bone, is elevated to facilitate access. Using specialized instruments such as drills, saws, and osteotomes, the surgeon then performs the bone cut in the predetermined configuration. In some cases, bone grafts may be interposed between the cut segments to promote healing and stability. It is important to note that this specific CPT® code, 27448, is designated for instances where the osteotomy is performed without the application of internal or external fixation devices. If fixation is required, a different code, 27450, should be utilized. This distinction is crucial for accurate medical coding and billing, ensuring that the procedure is documented correctly for reimbursement and compliance purposes.
© Copyright 2025 Coding Ahead. All rights reserved.
The osteotomy of the femur, specifically the shaft or supracondylar region, is indicated for various conditions that necessitate realignment or correction of the femoral bone structure. The following are common indications for this procedure:
The procedure for performing an osteotomy of the femur involves several critical steps, each designed to ensure the successful correction of the deformity. The following outlines the procedural steps:
After the osteotomy procedure, the patient will require specific post-operative care to ensure proper healing and recovery. This may include monitoring for any signs of complications, such as infection or improper healing. Patients are typically advised to limit weight-bearing activities on the affected leg for a specified period, allowing the bone to heal adequately. Follow-up appointments are essential to assess the healing process through radiographic evaluations. Rehabilitation may also be recommended to restore mobility and strength in the affected limb, with physical therapy tailored to the patient's needs. The overall recovery time can vary based on the individual patient's condition and adherence to post-operative care instructions.
| Short Descr | INCISION OF THIGH | Medium Descr | OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/O FIXATION | Long Descr | Osteotomy, femur, shaft or supracondylar; without fixation | 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 |
| 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. | 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). | 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. | 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 | 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) | 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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