CPT® Code 0547T

Official Description

Bone-material quality testing by microindentation(s) of the tibia(s), with results reported as a score

Common Language Description

Bone material quality testing by microindentation(s) is a specialized invasive diagnostic procedure aimed at assessing the mechanical properties of bone, particularly focusing on the stiffness of the cortical bone. This test is performed using a hand-held micro-indentation device that involves inserting a sterile probe through the skin to create a series of indentations or microscopic fractures in the tibia. The primary objective of this testing is to provide valuable insights into the bone's mechanical characteristics, which can significantly influence the outcomes of orthopedic implant procedures. Understanding the stiffness of the bone is crucial for surgeons, as it informs them about the amount of force required to properly seat an implant. For instance, stiffer bones necessitate greater force during implantation, while more pliant bones may require less force but could lead to a higher risk of implant loosening. This procedure is particularly relevant for elderly patients, who often exhibit more porous bones with diminished stiffness, thereby increasing the likelihood of complications such as a loose fit of prosthetic joints or fractures during the implantation process. The testing process involves careful positioning of the patient, administration of local anesthetic, and precise execution of indentation measurements, followed by a comparison of these measurements against a reference material to derive a bone material strength index score.

1. Indications

The bone material quality testing by microindentation(s) is indicated for the following conditions:

Assessment of Bone Quality This procedure is performed to evaluate the mechanical properties of bone, particularly in patients with conditions that may affect bone density and strength.
Preoperative Planning for Orthopedic Procedures It aids surgeons in determining the appropriate force required for implant placement, which is critical for ensuring the stability and longevity of orthopedic devices.
Evaluation of Osteoporosis The test is useful in assessing patients with osteoporosis or other metabolic bone diseases, where bone quality may be compromised.
Monitoring Bone Health in Elderly Patients It is particularly relevant for elderly patients who are at increased risk of fractures and implant complications due to changes in bone structure and quality.

2. Procedure

The procedure for bone material quality testing by microindentation(s) involves several key steps to ensure accurate measurement of bone stiffness.

Patient Positioning The patient is positioned supine to provide optimal access to the medial aspect of the tibia for the procedure.
Administration of Local Anesthetic A local anesthetic is administered to the area of the medial tibia to minimize discomfort during the testing process.
Insertion of the Probe The sterile probe tip of the micro-indentation device is carefully inserted through the skin and periosteum until it reaches the bone cortex, ensuring that the probe is positioned correctly for accurate measurements.
Adjustment of the Probe Angle The angle of the hand-held probe is adjusted to be perpendicular to the surface of the patient's leg, which is crucial for obtaining valid indentation measurements.
Indentation Measurements A series of 8-10 separate indentation measurements are taken on the tibia. Any measurements deemed invalid, typically the initial ones, are excluded from the final data set to ensure accuracy.
Reference Material Testing The indentation device is then used to perform a similar number of indentations on a separate reference material cube, using the same speed and perpendicular angle as with the patient’s tibia.
Data Analysis The device software compares the patient measurements to those obtained from the reference cube and calculates the results, which are reported as a bone material strength index score.

3. Post-Procedure

After the completion of the bone material quality testing, the patient may experience some localized discomfort at the site of the probe insertion, which typically resolves quickly. There are no specific post-procedure care instructions mentioned; however, it is advisable for the patient to monitor the site for any signs of infection or unusual swelling. The results of the test, reported as a bone material strength index score, will be used by the healthcare provider to inform further clinical decisions regarding orthopedic interventions and to assess the overall bone health of the patient.

Short Descr	B1 MATRL QUAL TST MCRIND TIB
Medium Descr	BONE MATRL QUALITY TST BY MICROINDENTATION TIBIA
Long Descr	Bone-material quality testing by microindentation(s) of the tibia(s), with results reported as a score
Status Code	Carriers Price the Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	0 - Physician Service Code
Multiple Procedures (51)	0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50)	0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Non-Covered Service, not paid under OPPS
Berenson-Eggers TOS (BETOS)	none
MUE	1