CPT® Code 25450

Epiphyseal arrest, as described by CPT® Code 25450, is a surgical procedure aimed at addressing specific orthopedic conditions related to the growth of the bones in the forearm, particularly the distal radius and ulna. The term "epiphyseal" refers to the epiphysis, which is the end part of a long bone, where growth occurs during childhood and adolescence. This procedure is typically indicated for patients experiencing an angulation deformity at the wrist or a discrepancy in bone length between the radius and ulna. The surgical approach involves making an incision over the distal aspect of the radius and/or ulna, extending down to the wrist joint. During the operation, careful dissection of the soft tissues is performed to protect vital blood vessels and nerves. Once the distal radius and/or ulna are adequately exposed, various devices such as Blount staples, transphyseal screws, or a plate and screw device are utilized to strategically arrest bone growth at the epiphysis. This arrest can be partial or complete, depending on whether the procedure is aimed at correcting an angulation deformity or addressing a bone length discrepancy. In cases of angulation deformity, only a portion of the epiphysis is treated, allowing for continued growth in the untreated portion, which helps to correct the deformity over time. Conversely, when addressing a bone length discrepancy, the entire epiphysis is arrested to prevent further growth. For coding purposes, CPT® Code 25450 is used for epiphyseal arrest of the radius or ulna, while CPT® Code 25455 is designated for procedures involving both bones.