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The
Coding Advocate
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CODING
TIP FOR 06/24/2008
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| ARTHRODIASTASIS |
| There are
a variety of pathological conditions that exist which cause
severe pain and debilitating degenerative conditions within
the joints, one of the more common conditions would be arthritis
(rheumatoid, degenerative, post-traumatic). The cartilage
becomes damaged to the point where there is formation of osteophytes
or lipping and this contributes to hallux limitus or rigidus
conditions and/or joint deterioration. Arthrodiastasis is
a surgical technique that has now become an alternative to
the more invasive procedures such as implant arthroplasty,
realignment osteotomies, or joint arthrodesis while offering
the following benefits; • Prevent bone on bone contact
within the joint decreasing pain and degeneration. •
Allows weight bearing during the postoperative period so that
the distracted joint can adapt to pressure changes in the
synovial fluid which increases proteoglycan metabolism reestablishing
cartilage health stabilizing and strengthening the joint.
• Releasing stress in subchondral bone decreasing the
risk of bone sclerosis that leads to lipping or rigidus conditions.
Arthrodiastasis involves gradual distraction of the joint;
this is accomplished by applying an external fixator which
is then used to stretch the joint capsule. It is critical
that the joint only be stretched 5mm – 10mm at a time
otherwise you may only achieve a “rubber band effect”
stretching the joint and then having it contract back to it’s
original position once the external fixator is removed. Fixation
system is commonly left in place for 6-10 weeks. You should
also note that any underlying deformity will not be corrected
such as the osteophtye lipping so an accompanying procedure
is usually necessary and critical to a successful outcome.
Hallux Limitus Joint Same Joint After Arthrodiastasis For
the purposes of CPT coding report the application of the external
fixation system and any accompanying procedure(s) performed
on the joint during that operative session. |
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All information contained in The Coding
Advocate is intended to comply with NCCI coding edits. Certain items can
vary by state and carrier. In the event you believe anything published
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