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Epiphyseal arrest, also known as epiphysiodesis, is a surgical procedure aimed at addressing discrepancies in bone length, particularly between the lower legs or between the tibia and fibula. The term "epiphysis" refers to the growth plate, which is a critical area of developing bone tissue that influences the length and shape of the bone as a child grows. In this procedure, a surgical incision is made over the distal aspect of the tibia, which is the larger bone in the lower leg. During the operation, soft tissues surrounding the bone are carefully dissected to expose the distal tibia and/or fibula while ensuring that vital blood vessels and nerves are protected. Once the bones are adequately exposed, various devices such as Blount staples, transphyseal screws, or a plate and screw device are strategically placed in the epiphysis of the distal tibia and/or fibula. These devices serve to temporarily halt the growth of the bone, thereby correcting the length discrepancy. The specific CPT® code 27730 is designated for the epiphyseal arrest of the distal tibia, while codes 27732 and 27734 are used for similar procedures on the distal fibula and both the distal tibia and fibula, respectively.
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Epiphyseal arrest is indicated for the treatment of conditions that result in a bone length discrepancy between the lower legs or between the tibia and fibula. This discrepancy can lead to functional impairments, gait abnormalities, and other complications if left unaddressed. The procedure is typically considered when the growth plates are still open, allowing for intervention to correct the length difference before skeletal maturity is reached.
The procedure for epiphyseal arrest involves several critical steps to ensure successful outcomes. First, the patient is positioned appropriately, and anesthesia is administered to ensure comfort during the surgery. Following this, a surgical incision is made over the distal aspect of the tibia and/or fibula. This incision allows the surgeon to access the underlying bone structures. Careful dissection of the soft tissues is performed, with particular attention paid to preserving surrounding blood vessels and nerves to prevent complications. Once the distal tibia and/or fibula are adequately exposed, the surgeon selects the appropriate device for the epiphyseal arrest. Options include Blount staples, transphyseal screws, or a plate and screw device, which are strategically placed in the epiphysis of the distal tibia and/or fibula. The placement of these devices is crucial as they temporarily halt the growth of the bone, effectively addressing the length discrepancy. After the devices are secured, the surgical site is closed in layers, and appropriate dressings are applied.
After the epiphyseal arrest procedure, patients typically require a period of recovery that may involve immobilization of the affected limb to ensure proper healing. Follow-up appointments are essential to monitor the surgical site for any signs of infection or complications. Patients may also undergo physical therapy to regain strength and mobility in the affected leg. The expected recovery time can vary based on individual factors, including the patient's age, overall health, and adherence to post-operative care instructions. It is important for patients to follow their healthcare provider's recommendations regarding activity restrictions and rehabilitation to achieve optimal outcomes.
| Short Descr | REPAIR OF TIBIA EPIPHYSIS | Medium Descr | ARREST EPIPHYSEAL OPEN DISTAL TIBIA | Long Descr | Arrest, epiphyseal (epiphysiodesis), open; distal 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) | 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 | 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 |
| 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. | 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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| 2003-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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