2025 CPT code 27360

Partial excision (craterization, saucerization, or diaphysectomy) of bone from the femur, proximal tibia, and/or fibula to address osteomyelitis or bone abscess.

Follow CPT guidelines for surgical procedures on the musculoskeletal system.Accurate documentation of the surgical technique (craterization, saucerization, or diaphysectomy) is crucial for appropriate coding.

Modifiers 50 (bilateral procedure), 51 (multiple procedures), 76 (repeat procedure), and 78 (unplanned return to OR) may be applicable depending on the specific circumstances.

Medical necessity for this procedure is established by the presence of a bone infection (osteomyelitis) or bone abscess that is unresponsive to conservative management (e.g., antibiotics, rest, immobilization). The procedure is necessary to remove the infected or necrotic bone tissue, allowing healing and preventing further complications.Documentation must support the failure of less invasive treatments.

The surgeon is responsible for all aspects of the procedure, from pre-operative planning and patient preparation to the surgical excision, hemostasis, and closure of the incision.Post-operative care may be shared with other healthcare professionals depending on the patient’s needs.

In simple words: The doctor removes a diseased or infected part of the thigh bone (femur), shin bone (tibia), or outer lower leg bone (fibula). This might involve cleaning out a small area of the bone (craterization or saucerization) or removing a larger section (diaphysectomy). This is usually done to treat a bone infection or abscess.If needed, the doctor will use a bone graft to fill any hole left behind.

This procedure involves the partial excision of bone from the femur, proximal tibia, and/or fibula.The specific technique (craterization, saucerization, or diaphysectomy) is chosen based on the extent and location of the diseased bone. The primary indications are osteomyelitis (bone infection) and bone abscess.The procedure includes incision, exposure of the periosteum, removal of diseased bone (potentially including a portion of the shaft), and closure of the incision.A bone graft may be used to fill any resulting cavity.Hemostasis is ensured throughout the procedure.

Example 1: A 55-year-old male patient presents with chronic osteomyelitis of the proximal tibia following a previous tibial fracture.The surgeon performs a saucerization of the affected bone to remove the infected tissue., A 28-year-old female patient with acute osteomyelitis of the femur undergoes a diaphysectomy to remove the infected portion of the bone shaft. A bone graft is used for reconstruction., A 72-year-old male patient with a bone abscess in the fibula undergoes a craterization procedure to remove the purulent material and infected bone.

* Thorough history and physical examination documenting the patient's symptoms, including pain, swelling, and any history of trauma or infection.* Imaging studies (X-rays, CT scans, MRI) to identify the location and extent of the bone lesion.* Microbiology results (if applicable) to determine the causative organism and guide antibiotic therapy.* Operative report detailing the surgical technique, amount of bone removed, and use of any bone grafts.* Pathology report confirming the diagnosis (e.g., osteomyelitis, bone abscess).* Post-operative imaging studies to assess healing.

** This procedure may be performed in conjunction with other procedures, such as debridement, bone grafting, or arthrodesis.Always refer to the latest CPT guidelines and payer specific instructions.

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