CPT® Code 26992

The procedure described by CPT® Code 26992 involves making an incision in the bone cortex of the pelvis and/or hip joint, specifically targeting conditions such as osteomyelitis or a bone abscess. The bone cortex is the outer layer of the bone, and in this case, it pertains to bones in the pelvic region or the hip joint, which includes critical structures like the head or neck of the femur. The surgical process begins with an incision through the skin and soft tissue that covers the infected area of the bone. This incision allows access to the periosteum, which is the dense layer of vascular connective tissue enveloping the bones, and is elevated to expose the underlying bone. A small section, referred to as a button of cortical bone, is then removed to access the bone marrow beneath. This step is crucial as it alleviates pressure that may have built up due to inflammation in the bone marrow, thereby restoring blood flow to the affected area. If pus is present, indicating an infection, the initial incision may be enlarged using specialized instruments such as a chisel or gouge, allowing for further drainage and treatment of the abscess. In cases where the epiphysis, the end part of a long bone, is also affected, a portion of the epiphyseal cortex may be excised to ensure complete drainage and treatment of the infection.