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Epiphyseal arrest, as described by CPT® Code 27477, is a surgical procedure aimed at addressing bone length discrepancies, particularly between the tibia and fibula at their proximal ends. The term "epiphyseal" refers to the epiphysis, which is the growth plate located at the ends of long bones. This procedure is typically indicated when there is a significant difference in length between the femurs or between the tibia and fibula, which can lead to functional impairments or cosmetic concerns. During the procedure, a surgical incision is made over the distal aspect of the femur and/or the proximal aspect of the tibia and/or fibula. Careful dissection of the surrounding soft tissues is performed to avoid damaging critical blood vessels and nerves. Once the distal femur and/or proximal tibia and/or fibula are adequately exposed, various devices such as Blount staples, transphyseal screws, or a plate and screw device are strategically placed in the epiphysis. These devices serve to temporarily halt the growth of the bone, thereby allowing for the correction of the length discrepancy. It is important to note that CPT® Code 27475 is used for epiphyseal arrest of the distal femur, while CPT® Code 27479 is applicable when the procedure involves both the distal femur and the proximal tibia and fibula.
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Post-procedure care typically involves monitoring for any complications and ensuring proper healing of the surgical site. Patients may require follow-up visits to assess the effectiveness of the epiphyseal arrest and to monitor bone growth. Rehabilitation may also be necessary to restore function and mobility, depending on the extent of the procedure and the individual patient's needs.
| Short Descr | SURGERY TO STOP LEG GROWTH | Medium Descr | ARREST EPIPHYSEAL TIBIA & FIBULA PROXIMAL | Long Descr | Arrest, epiphyseal, any method (eg, epiphysiodesis); tibia and fibula, proximal | 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) | 1 - Statutory payment restriction for assistants at surgery applies 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 | Hospital Part B services paid through a comprehensive APC | 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. | 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) |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2002-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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