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Hemiepiphyseal arrest is a surgical procedure aimed at correcting angulation deformities of the leg, specifically conditions such as genu varus, commonly known as bowleg, and genu valgus, referred to as knock-knee. The term "epiphysis" denotes the growth plate of the bone, which is crucial for the longitudinal growth of the skeletal system. During this procedure, a surgical incision is made over the distal end of the femur or the proximal ends of the tibia or fibula, allowing access to the underlying bone structures. Careful dissection of the surrounding soft tissues is performed to safeguard vital blood vessels and nerves that may be present in the area. Once the distal femur or proximal tibia or fibula is adequately exposed, various devices such as Blount staples, transphyseal screws, or a plate and screw system are employed. These devices are strategically placed within the epiphysis to temporarily halt bone growth in a targeted manner. It is important to note that only a specific portion of the epiphysis is subjected to this arrest, while the remaining portion is left untreated, allowing for continued growth. This selective approach effectively diminishes or corrects the angulation deformity, facilitating improved alignment of the leg over time.
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The hemiepiphyseal arrest procedure is indicated for the treatment of specific angulation deformities of the leg. The following conditions are explicitly recognized as indications for this surgical intervention:
The hemiepiphyseal arrest procedure involves several critical steps to ensure effective treatment of the angulation deformity. The following procedural steps are outlined:
Post-procedure care following hemiepiphyseal arrest is essential for ensuring optimal recovery and monitoring the effectiveness of the treatment. Patients are typically advised to follow specific guidelines, which may include restrictions on weight-bearing activities to allow for proper healing. Regular follow-up appointments are necessary to assess the alignment of the leg and the growth of the untreated portion of the epiphysis. Additionally, physical therapy may be recommended to aid in rehabilitation and to strengthen the surrounding muscles. It is important for healthcare providers to monitor for any potential complications, such as infection or improper healing, to ensure a successful outcome.
| Short Descr | SURGERY TO STOP LEG GROWTH | Medium Descr | ARRST HEMIEPIPHYSL DSTL FEMUR/PROX TIBIA/FIBULA | Long Descr | Arrest, hemiepiphyseal, distal femur or proximal tibia or fibula (eg, genu varus or valgus) | 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) | 0 - Co-surgeons not permitted for this procedure. | 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 |
| 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). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 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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| Pre-1990 | Added | Code added. |
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