CPT® Code 23180

The procedure described by CPT® Code 23180 involves a partial excision of bone, specifically targeting the clavicle to address osteomyelitis, which is an infection of the bone. This surgical intervention may also be referred to by terms such as craterization, saucerization, or diaphysectomy. Craterization and saucerization are techniques that focus on removing infected and necrotic bone tissue to create a shallow depression on the bone surface, facilitating drainage from the infected area. In contrast, diaphysectomy pertains to the removal of the infected segment of the shaft of a long bone. The procedure begins with an incision through the skin and soft tissue over the osteomyelitis site, allowing access to the affected area. The surgeon meticulously resects any soft tissue sinus tracts and devitalized soft tissue to expose the necrotic and infected bone. The surgical approach includes creating a series of drill holes in the compromised bone, followed by excavation of the bone between these holes to form an oval window using an osteotome. The extent of bone removal is determined by the severity of the infection. Additionally, a curette may be employed to eliminate any devitalized tissue from the medullary canal. The debridement process continues until punctate bleeding is observed on the exposed bony surface, indicating that healthy tissue has been reached. Once all infected and necrotic tissue has been thoroughly removed, the surgical site is irrigated with sterile saline or an antibiotic solution to reduce the risk of further infection. Finally, the wound is loosely closed, and a drain is placed to facilitate fluid drainage post-operatively.