Overview of CPT Code 21408: Open treatment of humeral shaft fracture

CPT Code 21408 refers to the surgical procedure for the open treatment of a fracture in the shaft of the humerus, which is the long bone in the upper arm. This procedure is typically performed when a fracture is displaced or unstable, requiring surgical intervention to ensure proper alignment and healing.

When CPT Code 21408 is Used?

This procedure is indicated in specific clinical scenarios.

Displaced humeral shaft fractures that cannot be aligned properly with non-surgical methods.
Fractures associated with significant soft tissue injury.
Fractures that are unstable and at risk of nonunion or malunion.
Fractures in patients who are active and require a stable arm for function.

Symptoms Indicating This Procedure

Patients may present with various symptoms that suggest the need for surgical intervention.

Severe pain in the upper arm.
Swelling and bruising around the fracture site.
Inability to move the arm or shoulder.
Deformity or abnormal positioning of the arm.

Causes and Risk Factors

Understanding the causes and risk factors can help in prevention.

Trauma from falls, sports injuries, or accidents.
Osteoporosis or other conditions that weaken bones.
High-impact activities or contact sports.
Previous fractures or surgeries in the area.

Diagnostic Tests Before Procedure

Several diagnostic tests are performed to confirm the need for surgery.

X-rays to visualize the fracture and assess alignment.
CT scans for detailed imaging of complex fractures.
MRI if soft tissue injury is suspected.

Procedure Description

The open treatment of a humeral shaft fracture involves several key steps.

Administer anesthesia to ensure patient comfort.
Make an incision over the fracture site to access the bone.
Realign the fractured bone fragments to restore normal anatomy.
Stabilize the fracture using plates, screws, or intramedullary nails.
Close the incision with sutures or staples.

Preparation for the Procedure

Proper preparation is essential for a successful surgery.

Avoid eating or drinking for at least 8 hours before surgery.
Discuss any medications with your surgeon, especially blood thinners.
Arrange for transportation to and from the hospital.
Wear loose, comfortable clothing on the day of the procedure.

Recovery and Aftercare

Post-operative care is crucial for healing.

Expected recovery period is typically 6 to 12 weeks.
Keep the surgical site clean and dry; follow wound care instructions.
Pain management may include prescribed medications.
Physical therapy may be recommended to regain strength and mobility.

Possible Complications

While complications are rare, they can occur.

Infection at the surgical site.
Nerve or blood vessel damage.
Nonunion or malunion of the fracture.
Stiffness or loss of motion in the shoulder or elbow.

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Post-Procedure Follow-Up

Regular follow-up is important to monitor healing.

Initial follow-up appointment within 1 to 2 weeks post-surgery.
Subsequent visits every 4 to 6 weeks to assess healing.
X-rays may be taken to ensure proper alignment and healing.

Alternative Treatments

Non-surgical options may be considered in certain cases.

Immobilization with a brace or sling for non-displaced fractures.
Physical therapy to strengthen surrounding muscles.
Pain management with medications and rest.

Home Care Tips

Patients can take steps to aid their recovery at home.

Follow all post-operative care instructions from your surgeon.
Keep the arm elevated to reduce swelling.
Engage in gentle movements as advised by your physical therapist.
Monitor for signs of infection, such as increased redness or drainage.

Patient Education & Prevention

Education is key to preventing future injuries.

Maintain bone health through diet and exercise.
Use protective gear during sports and high-risk activities.
Avoid activities that increase the risk of falls, especially in older adults.

Billing and Coding Information

CPT Code: 21408

Category: Surgical Procedures

Common Modifiers:

50 - Bilateral procedure
RT - Right side
LT - Left side

Average Cost and Insurance Coverage

Costs can vary based on several factors.

Average cost ranges from $10,000 to $20,000 depending on facility and location.
Most insurance plans cover the procedure, but patients should verify with their provider.