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An open osteochondral autograft is a surgical procedure that involves the transplantation of bone and cartilage tissue from one area of the patient's body to the talus, which is a bone in the ankle. This procedure is typically performed to address conditions such as osteochondritis dissecans, a disorder characterized by the separation of a fragment of bone and cartilage from the underlying bone, leading to pain and dysfunction in the ankle joint. The procedure begins with the creation of an incision over the affected area of the ankle, allowing the surgeon to access the joint capsule through an arthrotomy. In some cases, an osteotomy of the medial or lateral malleolus may be necessary to provide adequate access to the lesion on the talus. The damaged tissue is carefully debrided to prepare the site for the graft. The osteochondral autograft is harvested from a healthy area, often from the patient's knee, although it can also be taken from the talar articular facet near the lesion. The harvesting process requires precision, as the graft must be obtained in a manner that preserves the integrity of the tissue. Once harvested, the graft is shaped and sized to fit the prepared recipient site on the talus, ensuring a proper fit to promote healing and integration. This meticulous process is repeated until the defect in the talus is adequately filled or until no further healthy tissue is available for harvesting.
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The open osteochondral autograft procedure is indicated for specific conditions affecting the talus, particularly:
The procedure involves several critical steps to ensure successful grafting of the osteochondral tissue:
After the open osteochondral autograft procedure, patients typically require a period of rehabilitation to promote healing and restore function. Post-procedure care may include immobilization of the ankle joint to allow for proper integration of the graft. Patients are often advised to follow a structured physical therapy program to gradually regain strength and mobility. Monitoring for any signs of complications, such as infection or graft failure, is also essential during the recovery phase. The expected recovery time can vary based on individual factors, including the extent of the procedure and the patient's overall health.
| Short Descr | OSTEOCHONDRAL TALUS AUTOGRFT | Medium Descr | OPEN OSTEOCHONDRAL AUTOGRAFT TALUS | Long Descr | Open osteochondral autograft, talus (includes obtaining graft[s]) | 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 | 147 - Treatment, fracture or dislocation of lower extremity (other than hip or femur) |
| 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. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | 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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| 2008-01-01 | Added | First appearance in code book in 2008. |
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