CPT® Code 25455

Epiphyseal arrest, specifically through the procedure of epiphysiodesis or stapling, is a surgical intervention aimed at addressing issues 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, initially growing separately from the shaft. This area is commonly known as the growth plate, where bone growth occurs during childhood and adolescence. The procedure is indicated for patients experiencing an angulation deformity at the wrist or a discrepancy in bone length between the radius and ulna. During the surgery, an incision is made over the distal aspect of the radius and/or ulna, extending down to the wrist joint. Careful dissection of the soft tissues is performed to avoid damaging surrounding 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 place within the epiphysis. This placement temporarily halts the growth of the bone. In cases where the procedure is aimed solely at correcting an angulation deformity, only a portion of the epiphysis is arrested, allowing the remaining portion to continue growing and thus correcting the deformity. Conversely, if the procedure is intended to address a bone length discrepancy, the entire epiphysis is arrested. It is important to note that CPT® Code 25450 should be used for epiphyseal arrest of either the radius or ulna alone, while CPT® Code 25455 is designated for procedures involving both the radius and ulna.