LCD Reference Article Article

Fracture of Ribs with Internal Fixation

A53931

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Draft Article
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NOT AN LCD REFERENCE ARTICLE
This article is not in direct support of an LCD.

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General Information

Source Article ID
N/A
Article ID
A53931
Original ICD-9 Article ID
A53929
Article Title
Fracture of Ribs with Internal Fixation
Article Type
Article
Original Effective Date
10/01/2015
Revision Effective Date
02/26/2018
Revision Ending Date
N/A
Retirement Date
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Article Text

Most injuries to the chest wall do not result in long-term respiratory dysfunction and operative indications for chest wall injuries are rare. Recent studies have explored the option of internal fixation of rib fracture for treatment of complex rib fractures, including flail chest, open fracture, symptomatic nonunion, and thoracotomy for other indications. Flail chest is diagnosed when multiple, consecutive ribs are fractured in two or more places, creating an incompetent region of the chest wall.

Internal Fixation is indicated to stabilize and provide fixation for fractures, fusions, and osteotomies of the ribs. The Modular RibLoc System consists of plates and screws for fractures, fusions, and osteotomies. The plates are pre-contoured to minimize bending that is done intra-operatively. Instrumentation is supplied with the implants to aid in the insertion of the plates and screws. All plates and screws are manufactured from titanium or titanium alloy.

Palmetto GBA will cover CPT codes 21812 and 21813. CPT 21811 is not covered, as in most instances fractures involving 1-3 ribs do not require internal fixation.

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Coding Information

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Revision History Information

Revision History Date Revision History Number Revision History Explanation
02/26/2018 R3 The Jurisdiction "J" Part B Contracts for Alabama (10112), Georgia (10212) and Tennessee (10312) are now being serviced by Palmetto GBA. Effective 02/26/18, these three contract numbers are being added to this article. No coverage, coding or other substantive changes (beyond the addition of the 3 Part B contract numbers) have been completed in this revision.
10/01/2015 R2

Annual validation with no revisions made.

10/01/2015 R1 Performed annual validation. No changes were made.
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Associated Documents

Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
Related Local Coverage Documents
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SAD Process URL 2
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Public Versions
Updated On Effective Dates Status
01/31/2018 02/26/2018 - N/A Currently in Effect You are here
Some older versions have been archived. Please visit the MCD Archive Site to retrieve them.

Keywords

  • Fracture
  • Ribs