Overview of CPT Code 21423: Open treatment of humeral shaft fracture
CPT Code 21423 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 realign and stabilize the bone.
When CPT Code 21423 is Used?
This procedure is indicated in several 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 with high functional demands requiring precise alignment.
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 and management.
- Traumatic injuries from falls, sports, 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 essential for confirming the need for surgery.
- X-rays to visualize the fracture and assess alignment.
- CT scans for detailed imaging of complex fractures.
- MRI to evaluate associated soft tissue injuries.
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 crucial for a successful outcome.
- 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 vital 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 restore function.
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 arm.
Secure, compliant, and built for trust
HIPAA-compliant and designed with privacy in mind, your patient’s data is protected. Focus on care while we safeguard your information.
Learn more
Post-Procedure Follow-Up
Regular follow-up is essential for monitoring recovery.
- 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 during follow-ups to monitor bone alignment.
Alternative Treatments
Non-surgical options may be considered in certain cases.
- Casting or splinting 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 instructions from your surgeon.
- Keep the arm elevated to reduce swelling.
- Engage in gentle movements as advised by your therapist.
- Monitor for signs of infection, such as increased redness or drainage.
Patient Education & Prevention
Education is key to preventing future injuries.
- Engage in strength training to support bone health.
- Use protective gear during high-risk activities.
- Maintain a healthy diet rich in calcium and vitamin D.
- Avoid high-impact sports if you have a history of fractures.
Billing and Coding Information
CPT Code: 21423
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.
- Insurance typically covers surgical procedures if deemed medically necessary.
- Out-of-pocket costs depend on the patient's insurance plan.
Related CPT Codes
- 21420 - Excision of benign skin lesion, face, ears, scalp, neck
- 21422 - Excision of benign skin lesion, face, ears, scalp, neck
References and Sources
Frequently Asked Questions (FAQs)
What is a humeral shaft fracture?
A humeral shaft fracture is a break in the long bone of the upper arm.
How long does recovery take?
Recovery typically takes 6 to 12 weeks, depending on the severity of the fracture.
Will I need physical therapy?
Yes, physical therapy is often recommended to restore strength and mobility.
What are the signs of infection?
Signs include increased redness, swelling, warmth, and drainage from the incision.
Can I return to sports after surgery?
Your doctor will advise when it is safe to return to sports based on your recovery.
