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Radical resection of a tumor in the tibia is a surgical procedure primarily indicated for the removal of malignant neoplasms, although it may also be necessary for benign tumors or tumors of indeterminate nature. This procedure involves making a skin incision directly over the site of the bone tumor or creating and elevating a skin flap to access the affected area. The surgical approach requires careful dissection of the overlying tissue to expose the tumor adequately. During the procedure, all bone and cartilage that show signs of tumor involvement are excised. The tumor is removed en bloc, meaning it is taken out in one piece along with a wide margin of surrounding healthy tissue to ensure complete removal of cancerous cells. This radical resection also necessitates the excision of all involved soft tissues, which may include muscles, tendons, fat, blood vessels, lymph vessels, nerves, and any tissues surrounding the joints. To confirm that all margins are free of tumor cells, a separately reportable frozen section may be performed during the procedure. If any margins indicate the presence of malignancy, additional tissue will be excised until clear margins are achieved. Post-surgery, drains may be placed as needed to prevent fluid accumulation, and the surgical wound can be closed in layers or may require separately reportable reconstructive procedures, depending on the extent of the resection. For coding purposes, the appropriate CPT® code for radical resection of a bone tumor of the tibia is 27645.
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Radical resection of a tumor in the tibia is indicated for the following conditions:
The procedure for radical resection of a tumor in the tibia involves several critical steps:
After the radical resection procedure, patients may require monitoring for complications such as infection or fluid accumulation. The expected recovery period will vary based on the extent of the surgery and the patient's overall health. Follow-up appointments are essential to assess healing and to review pathology results from the excised tumor. Additional treatments, such as chemotherapy or radiation, may be considered based on the final diagnosis and margins obtained during the procedure. Proper post-operative care and adherence to follow-up schedules are crucial for optimal recovery and management of any further treatment needs.
| Short Descr | RESECT TIBIA TUMOR | Medium Descr | RADICAL RESECTION OF TUMOR TIBIA | Long Descr | Radical resection of tumor; tibia | 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 | 142 - Partial excision bone |
This is a primary code that can be used with these additional add-on codes.
| 20932 | Add-on Code MPFS Status: Active Code APC N ASC N1 Allograft, includes templating, cutting, placement and internal fixation, when performed; osteoarticular, including articular surface and contiguous bone (List separately in addition to code for primary procedure) | 20933 | Add-on Code MPFS Status: Active Code APC N ASC N1 Allograft, includes templating, cutting, placement and internal fixation, when performed; hemicortical intercalary, partial (ie, hemicylindrical) (List separately in addition to code for primary procedure) | 20934 | Add-on Code MPFS Status: Active Code APC N ASC N1 Allograft, includes templating, cutting, placement and internal fixation, when performed; intercalary, complete (ie, cylindrical) (List separately in addition to code for primary procedure) |
| 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. | 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) |
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| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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