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Radical resection of a tumor in the metacarpal bone is a surgical procedure primarily indicated for the removal of malignant neoplasms, although it may also be necessary for benign tumors or tumors of indeterminate nature. The procedure begins with the creation of a skin incision directly over the tumor site, or alternatively, a skin flap may be elevated to provide access. During the operation, the surgeon meticulously dissects the overlying tissue to expose the tumor. The radical resection involves the complete removal of all bone and cartilage within the metacarpal that is affected by the tumor. This is done en bloc, meaning the tumor is excised along with a wide margin of healthy surrounding tissue to ensure complete removal of cancerous cells. The procedure also necessitates the excision of all involved soft tissues, which can include muscles, tendons, fat, blood vessels, lymph vessels, nerves, and any tissues that are adjacent to the joints. To confirm that the surgical margins are free of tumor cells, a separately reportable frozen section may be performed during the procedure. If any margins are found to contain malignancy, further tissue is excised until all margins are confirmed to be clear of cancerous cells. Post-surgery, drains may be placed as necessary to manage fluid accumulation, and the surgical wound can be closed in layers, or additional reconstructive procedures may be performed if required.
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Radical resection of a tumor in the metacarpal is performed under specific clinical circumstances. The primary indications for this procedure include:
The radical resection of a tumor in the metacarpal bone involves several critical procedural steps, which are outlined as follows:
Post-procedure care following a radical resection of a tumor in the metacarpal bone involves monitoring for complications and ensuring proper healing. Patients may require pain management and should be observed for signs of infection or other postoperative complications. The surgical site will need to be kept clean and dry, and any drains placed during the procedure will be monitored for output. Follow-up appointments are essential to assess healing and to evaluate the need for any additional treatments or interventions. Rehabilitation may be necessary to restore function and strength in the affected hand, depending on the extent of the resection and the tissues involved.
| Short Descr | EXTENSIVE HAND SURGERY | Medium Descr | RADICAL RESECTION TUMOR METACARPAL | Long Descr | Radical resection of tumor, metacarpal | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5B - Ambulatory procedures - musculoskeletal | MUE | 2 | CCS Clinical Classification | 142 - Partial excision bone |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | F4 | Left hand, fifth digit | F5 | Right hand, thumb | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | T5 | Right foot, great toe |
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| 2010-01-01 | Changed | Code description changed. |
| 2002-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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