How To Use CPT Code 0594T

CPT 0594T describes a specific procedure for limb lengthening that involves the insertion of an externally controlled intramedullary lengthening device. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0594T.

1. What is CPT Code 0594T?

CPT 0594T is a code that represents a limb lengthening procedure that utilizes an externally controlled intramedullary lengthening device. This procedure involves the insertion of specially designed nails through the intramedullary canal of the humerus, which can be extended using an external controller. Over time, this allows new bone to grow in the space between the two sections of the humerus, effectively lengthening it.

2. Official Description

The official description of CPT code 0594T is: ‘Osteotomy, humerus, with insertion of an externally controlled intramedullary lengthening device, including intraoperative imaging, initial and subsequent alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device.’

3. Procedure

1. The procedure begins with the measurement of limb length and angles, as well as the selection of the osteotomy site using preoperative X-rays.
2. The patient is positioned supine on the operating table, and the provider marks the osteotomy level on the skin.
3. A small incision is made at the osteotomy site, and holes are drilled through the bone to vent the intramedullary canal.
4. A guidewire is inserted through the skin at the anterolateral border of the acromion and directed towards the proximal humerus, with its position confirmed using imaging guidance.
5. The provider incises the skin and subcutaneous tissue around the guidewire, spreads the deltoid muscle tissue and rotator cuff away, and reams the intramedullary canal of the humerus.
6. An appropriately sized nail is inserted into the starting hole and advanced across the osteotomy site, with any deformity corrected if necessary.
7. The position and alignment of the humerus are checked using Steinmann pins, and proximal locking screws are inserted.
8. The distraction of the nails is tested, and if necessary, the rotator cuff is repaired.
9. The wound is irrigated, checked for bleeding, and closed in layers, and the patient is placed in a shoulder-arm immobilizer.
10. About a week after surgery, the patient will use a remote controller to distract the nails at a predetermined schedule and amount of distraction, which can be adjusted based on follow-up imaging.

4. Qualifying circumstances

CPT 0594T is applicable to patients who require limb lengthening and meet specific criteria. It should not be reported in conjunction with certain other codes related to the procedure. Revision of an externally controlled intramedullary lengthening device should be reported using a different code. It is important to review the specific guidelines and documentation requirements for accurate reporting.

5. When to use CPT code 0594T

CPT code 0594T should be used when performing the described limb lengthening procedure with the insertion of an externally controlled intramedullary lengthening device. It is important to ensure that the procedure meets the criteria outlined in the official description and that it is not being reported with other codes that are not appropriate for this specific procedure.

6. Documentation requirements

To support a claim for CPT code 0594T, the provider must document various aspects of the procedure, including the specific details of the surgery, such as the osteotomy site, the insertion of the intramedullary lengthening device, and any adjustments made. Documentation should also include preoperative and postoperative imaging, initial and subsequent alignment assessments, and computations of adjustment schedules. It is crucial to accurately record all relevant information to ensure proper billing and reimbursement.

7. Billing guidelines

When billing for CPT code 0594T, it is important to follow the specific guidelines and ensure that the procedure meets the necessary criteria. The provider should not report this code in conjunction with certain other codes related to the procedure. It is also important to consider any additional tips or recommendations provided by the payer to avoid denials or delays in reimbursement.

8. Historical information

CPT code 0594T was added to the Current Procedural Terminology system on July 1, 2020. As of now, there have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoes a limb lengthening procedure using an externally controlled intramedullary lengthening device to correct a congenital limb length discrepancy.
2. A provider performs an osteotomy of the humerus and inserts an intramedullary lengthening device to address a limb length discrepancy resulting from a previous injury.
3. A patient with a limb length discrepancy due to a medical condition undergoes a limb lengthening procedure using an externally controlled intramedullary lengthening device.
4. A provider performs a limb lengthening procedure on a patient with dwarfism using an externally controlled intramedullary lengthening device to improve their overall stature.
5. A patient with a limb length discrepancy resulting from a bone infection undergoes a limb lengthening procedure using an externally controlled intramedullary lengthening device to restore proper limb alignment.
6. A provider performs a limb lengthening procedure on a patient with a congenital limb deformity using an externally controlled intramedullary lengthening device to improve their functional mobility.
7. A patient with a limb length discrepancy due to a previous surgical intervention undergoes a limb lengthening procedure using an externally controlled intramedullary lengthening device to achieve better symmetry and balance.
8. A provider performs a limb lengthening procedure on a patient with a limb length discrepancy resulting from a traumatic injury using an externally controlled intramedullary lengthening device to restore proper limb alignment.
9. A patient with a limb length discrepancy due to a genetic condition undergoes a limb lengthening procedure using an externally controlled intramedullary lengthening device to improve their overall quality of life.
10. A provider performs a limb lengthening procedure on a patient with a limb length discrepancy resulting from a bone tumor using an externally controlled intramedullary lengthening device to restore proper limb alignment and function.