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The proximal tibiofibular joint is a critical synovial joint located at the back and side of the knee, specifically between the lateral condyle of the tibia and the head of the fibula. Synovial joints, such as this one, are characterized by their structure, which includes a joint cavity filled with synovial fluid, providing lubrication and reducing friction during movement. The surfaces of these joints are covered with hyaline cartilage or fibrocartilage, which aids in shock absorption and smooth articulation. Additionally, the stability of the proximal tibiofibular joint is maintained by a joint capsule and surrounding ligaments, which help to prevent dislocation and injury. In cases where dislocation occurs, closed treatment involves the application of manual pressure to realign the joint back to its normal anatomical position. This procedure is performed under anesthesia to ensure patient comfort and minimize pain during the manipulation. Following the successful reduction of the dislocation, which is confirmed through the use of radiographs that are reported separately, a splint or cast may be applied to immobilize the joint and facilitate proper healing. It is important to note that if the procedure is conducted without the need for general anesthesia, the appropriate code to use is 27830, whereas 27831 is designated for cases requiring general anesthesia.
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The closed treatment of proximal tibiofibular joint dislocation is indicated in cases where there is a dislocation of the joint, which may present with symptoms such as pain, swelling, and limited mobility in the knee area. This procedure is typically performed when the dislocation requires intervention to restore normal joint alignment and function.
The closed treatment of proximal tibiofibular joint dislocation involves several key procedural steps to ensure effective realignment of the joint. First, the patient is positioned appropriately, and general anesthesia is administered to ensure comfort and minimize pain during the procedure. Once the patient is adequately anesthetized, the physician will assess the dislocation and apply manual pressure to the proximal tibiofibular joint. This pressure is carefully directed to guide the joint back into its correct anatomical position. After the joint has been successfully reduced, the physician will verify the alignment through radiographic imaging, which is reported separately to confirm that the joint has returned to its proper location. Following this verification, if necessary, a splint or cast may be applied to immobilize the joint and support the healing process. This immobilization is crucial to prevent re-dislocation and to allow for adequate recovery of the joint structures.
After the closed treatment of proximal tibiofibular joint dislocation, the patient will typically be monitored for any immediate complications related to the procedure. Post-procedure care may include instructions for rest, elevation of the affected limb, and the use of ice to reduce swelling. The physician may also provide guidelines on the duration of immobilization and when to follow up for further evaluation. Patients are advised to avoid weight-bearing activities until cleared by their healthcare provider to ensure proper healing and to prevent re-injury.
| Short Descr | TREAT LOWER LEG DISLOCATION | Medium Descr | CLTX PROX TIBFIB JT DISLC REQ ANES | Long Descr | Closed treatment of proximal tibiofibular joint dislocation; requiring anesthesia | 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) | P5B - Ambulatory procedures - musculoskeletal | MUE | 1 | CCS Clinical Classification | 147 - Treatment, fracture or dislocation of lower extremity (other than hip or femur) |
| 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. | 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.) | 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) |
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| Pre-1990 | Added | Code added. |
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