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The closed treatment of distal femoral epiphyseal separation, as described by CPT® Code 27517, involves the management of a specific type of injury to the growth plate, known as the epiphysis, located at the end of the femur (thigh bone). The epiphyseal plate is crucial for bone growth, and any separation in this area can lead to significant complications, including the potential for halted bone growth and leg length discrepancies. This procedure is indicated when there is a minimally displaced separation of the distal femoral epiphysis, which typically occurs due to trauma. The treatment aims to restore the normal anatomical alignment of the bone fragments to ensure proper healing and continued growth. During the procedure, closed reduction techniques are employed, which means that the bones are manipulated back into place without the need for surgical incisions. This manipulation may be supplemented with skin or skeletal traction to maintain the correct positioning of the bone fragments and to prevent further displacement. Radiographic imaging is utilized to confirm that the bone fragments are properly aligned after the reduction. If traction is necessary, it can be applied using various methods, including skin traction, which involves external devices, or skeletal traction, which involves internal fixation devices. Ultimately, if traction is not utilized, the affected leg is immobilized in a long leg or hip spica cast to ensure stability during the healing process.
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The closed treatment of distal femoral epiphyseal separation is indicated for the following conditions:
The procedure for closed treatment of distal femoral epiphyseal separation involves several key steps:
Post-procedure care for patients undergoing closed treatment of distal femoral epiphyseal separation includes monitoring for signs of complications, such as improper healing or infection. Patients are typically advised to limit weight-bearing activities on the affected leg during the initial recovery phase. Follow-up appointments are necessary to assess the healing process through additional radiographic evaluations. The duration of immobilization in a cast may vary based on the individual case and the physician's assessment of healing progress. Rehabilitation exercises may be introduced gradually to restore mobility and strength once the physician determines that it is safe to do so.
| Short Descr | TREAT THIGH FX GROWTH PLATE | Medium Descr | CLTX DSTL FEM EPIPHYSL SEP W/MANJ W/WO SKIN/SKEL | Long Descr | Closed treatment of distal femoral epiphyseal separation; with manipulation, with or without skin or skeletal traction | 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) | 0 - 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 | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 146 - Treatment, fracture or dislocation of hip and femur |
| 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). | 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. | 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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