CPT® Code 21812

Open treatment of rib fracture(s) with internal fixation, includes thoracoscopic visualization when performed, unilateral; 4-6 ribs

The procedure described by CPT® Code 21812 involves the open treatment of rib fractures, specifically addressing cases where there are 4 to 6 fractures present. This surgical intervention is characterized by the use of open reduction and internal fixation (ORIF) techniques, which are essential for properly aligning and stabilizing the fractured ribs. The term 'unilateral' indicates that the procedure is performed on one side of the rib cage. In some instances, thoracoscopic visualization may be utilized during the surgery, allowing the surgeon to examine the pleural cavity for any potential complications such as bleeding or damage to surrounding visceral organs. The surgical approach begins with a standard thoracotomy incision, which is made over the area of injury, and involves careful dissection through the skin, subcutaneous tissue, and fascia to access the ribs. The procedure requires meticulous attention to avoid damaging the intercostal neurovascular bundles, which are critical structures located along the inferior aspect of the ribs. Once the fractures are exposed, the surgeon cleans the fracture sites, removes any nonunion fibrous tissue, and then mobilizes, reduces, and secures the fractured rib ends using various fixation devices. The closure of the surgical site involves reapproximating the muscles, closing the fascia and subcutaneous tissue with interrupted stitches, and finally securing the skin with staples. This comprehensive approach ensures that the rib fractures are effectively treated, promoting optimal healing and recovery.