CPT® Code 23184

The procedure described by CPT® Code 23184 involves a partial excision of bone, specifically targeting the proximal humerus 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, involves 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 site of infection, allowing access to the affected area. During the operation, any soft tissue sinus tracts and devitalized soft tissue are excised to ensure a clean surgical field. The surgeon then exposes the necrotic and infected bone, employing a series of drill holes to facilitate the excavation of the bone between these holes, ultimately forming an oval window. The extent of bone removal is determined by the severity of the infection. Additionally, a curette may be utilized to clear out any devitalized tissue from the medullary canal. The debridement process continues until healthy bone is reached, indicated by the presence of punctate bleeding on the exposed surface. Following the removal of all compromised tissue, the surgical site is thoroughly irrigated with sterile saline or an antibiotic solution to minimize the risk of further infection. Finally, the wound is loosely closed, and a drain is placed to allow for any potential fluid accumulation post-surgery.