Overview of CPT Code 21435:Repair of fractured clavicle
CPT Code 21435 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 21435 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 in the shoulder or collarbone area.
- Swelling and bruising around the fracture site.
- Limited range of motion in the shoulder.
- Visible deformity or abnormal positioning of the clavicle.
Causes and Risk Factors
Understanding the causes and risk factors can help in prevention and management.
- Traumatic injuries from falls, sports, or accidents.
- High-impact activities that increase the risk of fractures.
- Osteoporosis or other conditions that weaken bones.
Diagnostic Tests Before Procedure
Several diagnostic tests may be performed to confirm the need for surgery:
- X-rays to visualize the fracture and assess displacement.
- CT scans for detailed imaging of complex fractures.
- Physical examination to evaluate symptoms and functionality.
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 for surgery:
- Avoid eating or drinking after midnight before the surgery.
- Discuss any medications with the healthcare provider.
- Arrange for transportation to and from the surgical facility.
Recovery and Aftercare
Post-operative recovery typically includes:
- Wearing a sling for support during the healing process.
- Taking prescribed pain medications as needed.
- Attending follow-up appointments to monitor healing.
Possible Complications
While complications are rare, they can occur and may include:
- Infection at the surgical site.
- Nerve or blood vessel damage.
- Nonunion or malunion of the fracture.
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Post-Procedure Follow-Up
Follow-up care is crucial for optimal recovery:
- Initial follow-up within 1-2 weeks post-surgery.
- Regular check-ups every few weeks to assess healing.
- Physical therapy may be recommended to regain strength.
Alternative Treatments
Non-surgical options may be considered in certain cases:
- Immobilization with a sling for non-displaced fractures.
- Pain management with medications.
- Physical therapy to improve mobility and strength.
Home Care Tips
Patients can follow these tips for effective home care:
- Keep the surgical area clean and dry.
- Follow the prescribed medication schedule.
- Engage in gentle movements as advised by the doctor.
Patient Education & Prevention
Educating patients on prevention can reduce recurrence:
- 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.
Billing and Coding Information
CPT Code: 21435
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.
Related CPT Codes
References and Sources
Frequently Asked Questions (FAQs)
What is a clavicle fracture?
A clavicle fracture is a break in the collarbone, often caused by trauma.
How long does recovery take?
Recovery typically takes 6 to 12 weeks, depending on the severity.
Will I need physical therapy?
Yes, physical therapy is often recommended to regain strength and mobility.
What are the signs of complications?
Signs include increased pain, swelling, or fever at the surgical site.
