Summary & Overview
CPT 23170: Excision of Clavicle Sequestrum
CPT code 23170 denotes the surgical excision of a sequestrum from the clavicle — removal of a necrotic bone fragment most often associated with osteomyelitis or chronic bone infection. Nationally, this code captures a targeted orthopedic procedure that can be integral to infection control, pain relief, and restoration of local bone health. It is relevant across hospital inpatient settings, ambulatory surgical centers, and outpatient operating rooms where orthopedic and surgical services are provided. Key payers addressed in standard coverage considerations include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. This publication provides clinical context for CPT code 23170, outlines typical sites of service, and explains the procedural focus. Readers will find a concise overview of the procedure’s clinical intent, the payers commonly involved in coverage decisions, and the types of benchmarks and policy updates that typically affect utilization and coding practices. Data not available in the input for detailed payer-specific reimbursement levels, associated taxonomies, and ICD-10 diagnoses are noted where applicable.
Billing Code Overview
CPT code 23170 describes the surgical excision of a sequestrum — a dead fragment of bone — from the clavicle (collarbone). This procedure addresses devitalized bone tissue typically resulting from chronic osteomyelitis or infection-related bone necrosis.
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Service type: Surgical debridement/excision of necrotic bone
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Typical site of service: Operating room or ambulatory surgical center for a procedure on the clavicle under appropriate anesthesia
Clinical & Coding Specifications
Clinical Context
A 52-year-old male presents with chronic pain, localized swelling, and intermittent drainage over the left clavicular region several months after a prior open fracture and hardware removal. Imaging (radiograph and CT) demonstrates a retained sequestrum within the midshaft clavicle consistent with chronic osteomyelitis. The surgical team schedules an operative procedure under general anesthesia to excise the necrotic bone fragment and irrigate the infected site. Preoperative workflow includes antibiotic administration per institutional protocol, informed consent detailing risks of persistent infection and potential need for additional debridement, and localization of the sequestrum with intraoperative fluoroscopy as needed. Intraoperatively, the surgeon exposes the clavicle through the existing incision, identifies and excises the sequestrum (CPT 23170), obtains deep tissue and bone cultures, performs thorough debridement of devitalized tissue, and achieves hemostasis. Postoperative workflow includes wound management, targeted antibiotic therapy guided by culture results, documentation of the excised specimen, and follow-up imaging or clinic visits to monitor for resolution of infection and wound healing. Typical site of service is an ambulatory surgical center or hospital operating room. The service type is operative debridement/excision of a sequestrum of the clavicle for treatment of chronic osteomyelitis or retained devitalized bone.
Coding Specifications
| Modifier | Description | When to Use |
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