CPT® Code 23490

The CPT® Code 23490 refers to the prophylactic treatment of the clavicle, which involves the use of various techniques such as nailing, pinning, plating, or wiring. This procedure is specifically designed to enhance the structural integrity of the clavicle, particularly in patients who are at risk due to conditions like osteoporosis or osteolytic diseases, which may arise from bone metastases. The treatment aims to provide additional strength and support to the bone, thereby reducing the likelihood of fractures or further complications. The techniques employed can vary; for instance, a percutaneous approach may be utilized where a small incision is made at the site of screw insertion. Radiographic guidance is often employed to accurately place pins or screws into the clavicle or proximal humerus. In some cases, a hollow cannulated screw may be inserted, allowing for the injection of bone cement, known as methylmethacrylate, directly into the bone to enhance its stability. Alternatively, the procedure may involve drilling into the bone to inject the cement directly. If a plate and screw or wire cerclage method is chosen, a larger incision is made to expose the bone, allowing for the placement of internal fixation devices that provide necessary support. The procedure concludes with a layered closure of the surgical site, ensuring proper healing and recovery.