Overview of CPT Code 21431: Repair of fractured clavicle

Overview of CPT Code 21431: Repair of fractured clavicle

CPT Code 21431 refers to the surgical repair of a fractured clavicle, a common injury often resulting from falls or direct impacts. This procedure aims to restore the normal anatomy and function of the clavicle.

When CPT Code 21431 is Used?

This code is applicable in various clinical scenarios, including:

• Displaced clavicle fractures requiring surgical intervention.
• Fractures that do not heal properly with conservative treatment.
• Fractures associated with significant pain or dysfunction.

Symptoms Indicating This Procedure

Patients may report the following symptoms:

• Severe pain at the site of the clavicle.
• Swelling and bruising over the shoulder.
• Limited range of motion in the arm.
• Visible deformity or abnormal positioning of the shoulder.

Causes and Risk Factors

Understanding the causes and risk factors can help in prevention.

• Trauma from falls, sports injuries, or vehicle accidents.
• Osteoporosis or other conditions that weaken bones.
• High-impact activities or contact sports.

Diagnostic Tests Before Procedure

Several tests may be conducted to confirm the diagnosis:

• X-rays to visualize the fracture.
• CT scans for detailed imaging if necessary.
• Physical examination to assess range of motion and pain.

Procedure Description

The surgical procedure typically involves the following steps:

• Administer anesthesia to ensure patient comfort.
• Make an incision over the fracture site.
• Realign the fractured ends of the clavicle.
• Secure the bone using plates, screws, or pins.
• Close the incision with sutures or staples.

Preparation for the Procedure

Patients should follow these steps to prepare:

• Avoid eating or drinking for several hours before surgery.
• Discuss medications with the surgeon, especially blood thinners.
• Arrange for transportation to and from the procedure.

Recovery and Aftercare

Post-operative recovery typically includes:

• Wearing a sling for support during healing.
• Pain management with prescribed medications.
• Gradual physical therapy to restore movement.

Possible Complications

While complications are rare, they can occur:

• Infection at the surgical site.
• Nonunion or malunion of the fracture.
• Nerve or blood vessel damage.

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Post-Procedure Follow-Up

Follow-up appointments are crucial for monitoring recovery:

• Initial follow-up within 1-2 weeks post-surgery.
• Regular check-ups to assess healing progress.
• Physical therapy sessions as recommended.

Alternative Treatments

Non-surgical options may include:

• Immobilization with a sling for non-displaced fractures.
• Pain management with medications.
• Physical therapy for rehabilitation.

Home Care Tips

Patients can follow these tips for better recovery:

• Keep the surgical area clean and dry.
• Follow medication instructions carefully.
• Engage in gentle exercises as advised by the doctor.

Patient Education & Prevention

Educating patients can help prevent future injuries:

• Engage in strength training to support bone health.
• Use protective gear during sports and activities.
• Maintain a healthy diet rich in calcium and vitamin D.

Billing and Coding Information

CPT Code: 21431

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 surgical costs range from $5,000 to $15,000.
• Insurance may cover a significant portion of the procedure.
• Out-of-pocket expenses depend on the specific insurance plan.

References and Sources

• Clavicle Fractures: Overview
• Surgical Management of Clavicle Fractures