Overview of CPT Code 22250:'Open treatment of clavicle fracture'

CPT Code 22250 refers to the open surgical treatment of a clavicle fracture, which involves realigning the broken bone and stabilizing it with hardware. This procedure is typically performed when a fracture is displaced or when conservative treatments have failed.

When CPT Code 22250 is Used?

This procedure is indicated in specific clinical scenarios.

Displaced clavicle fractures that cannot heal properly without surgical intervention.
Fractures associated with significant displacement or shortening of the clavicle.
Fractures that are open or involve skin penetration.
Fractures in patients with high functional demands or athletes.

Symptoms Indicating This Procedure

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

Severe pain at the site of the fracture.
Swelling and bruising over the shoulder area.
Inability to move the arm or shoulder without pain.
Visible deformity or abnormal positioning of the shoulder.

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.
Previous shoulder injuries that may predispose to fractures.

Diagnostic Tests Before Procedure

Several diagnostic tests are essential for confirming the need for surgery.

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

Procedure Description

The open treatment of a clavicle fracture involves several key steps.

Administer anesthesia to ensure patient comfort.
Make an incision over the fracture site to access the clavicle.
Realign the fractured bone fragments to their normal position.
Stabilize the fracture using plates, screws, or pins.
Close the incision with sutures and apply a dressing.

Preparation for the Procedure

Proper preparation is crucial for a successful surgery.

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

Recovery and Aftercare

Post-operative care is essential for optimal recovery.

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 or over-the-counter pain relievers.
Physical therapy may be recommended to restore strength and mobility.

Possible Complications

As with any surgical procedure, there are potential risks.

Infection at the surgical site.
Nonunion or malunion of the fracture.
Nerve or blood vessel injury.
Persistent pain or stiffness in the shoulder.

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Post-Procedure Follow-Up

Regular follow-up is important to monitor 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 ensure proper bone alignment.

Alternative Treatments

There are non-surgical options available for managing clavicle fractures.

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

Home Care Tips

Patients can take steps at home to aid recovery.

Follow all post-operative care instructions provided by your surgeon.
Keep the arm elevated to reduce swelling.
Engage in gentle range-of-motion exercises as advised.
Avoid heavy lifting or strenuous activities until cleared by your doctor.

Patient Education & Prevention

Education on prevention can help reduce the risk of future fractures.

Maintain bone health through a balanced diet rich in calcium and vitamin D.
Engage in regular weight-bearing exercises to strengthen bones.
Use protective gear during sports and high-risk activities.
Seek medical advice for any previous injuries or bone health concerns.

Billing and Coding Information

CPT Code: 22250

Category: Surgical Procedures

Common Modifiers:

Average Cost and Insurance Coverage

Costs can vary based on location and insurance.

Average cost ranges from $5,000 to $15,000 depending on facility and complexity.
Most insurance plans cover the procedure if deemed medically necessary.
Patients should verify coverage details with their insurance provider.