CPT® Code 23182

The procedure described by CPT® Code 23182 involves a partial excision of bone, specifically targeting the scapula to address osteomyelitis, which is an infection of the bone. This surgical intervention is also known by terms such as craterization, saucerization, or diaphysectomy. Craterization and saucerization refer to techniques that create a shallow depression in the bone surface by removing infected and necrotic bone, thereby facilitating drainage from the infected area. Diaphysectomy, on the other hand, 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 infected area. The surgeon meticulously resects any soft tissue sinus tracts and devitalized soft tissue to expose the necrotic and infected bone. A series of drill holes are then created in the affected bone, and the bone between these holes is excavated using an osteotome to form an oval window. 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 healthy tissue. Following the complete removal of all infected and necrotic tissue, the surgical site is thoroughly 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-surgery.