© Copyright 2025 American Medical Association. All rights reserved.
An osteotomy of the tibia and fibula involves surgical procedures aimed at correcting deformities or realigning the bones of the lower leg. This procedure can be performed on the shafts of the tibia and fibula, as well as on the distal ends of these bones. The specific type of osteotomy performed is determined by the nature and location of the deformity being addressed. Various techniques may be utilized, including transverse, wedge, sliding, right or left angle, V-osteotomy, and Z-osteotomy, each designed to achieve optimal alignment and function of the bones. Prior to the surgical intervention, the physician employs radiographic studies to accurately plan the bone cuts necessary for the procedure. The surgical process begins with an incision over the lower leg, followed by careful dissection of the soft tissues to expose the tibia and fibula. The periosteum, a dense layer of connective tissue surrounding the bones, is elevated to facilitate access. Using specialized instruments such as drills, saws, and osteotomes, the surgeon makes precise cuts in the bone according to the pre-determined configuration. In some cases, bone grafts may be inserted between the cut segments to promote healing and stability. To ensure that the bone edges remain properly aligned, various internal fixation devices, such as pins, screws, or plates, may be utilized. Alternatively, an external fixation device can be applied if necessary. This procedure is specifically coded as CPT® 27709 when both the tibia and fibula are involved in the osteotomy.
© Copyright 2025 Coding Ahead. All rights reserved.
The osteotomy of the tibia and fibula is indicated for various conditions that necessitate correction of bone deformities or realignment. The following are explicitly provided indications for this procedure:
The procedure for performing an osteotomy of the tibia and fibula involves several critical steps, each designed to ensure precision and effectiveness in correcting the deformity. The following procedural steps are outlined:
After the osteotomy procedure, patients typically require careful monitoring and follow-up care to ensure proper healing and recovery. Post-procedure care may include pain management, physical therapy, and regular follow-up appointments to assess the alignment and healing of the bones. Patients are often advised to limit weight-bearing activities on the affected leg for a specified period, as determined by the surgeon. The expected recovery time can vary based on the complexity of the procedure and the individual patient's healing response. It is essential for patients to adhere to the postoperative instructions provided by their healthcare team to optimize recovery outcomes.
| Short Descr | OSTEOTOMY TIBIA & FIBULA | Medium Descr | OSTEOTOMY TIBIA & FIBULA | Long Descr | Osteotomy; tibia and fibula | 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 | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | 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. | 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 | CR | Catastrophe/disaster related | ET | Emergency services | 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) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2025-01-01 | Changed | Short Description changed. |
| 2013-01-01 | Changed | Medium Descriptor changed. |
| Pre-1990 | Added | Code added. |
Get instant expert-level medical coding assistance.