0RGE44Z
Fusion Sternoclavicular Joint, Right to No Qualifier with Internal Fixation Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | R Upper Joints |
| Operation | G Fusion |
| Body Part | E Sternoclavicular Joint, Right |
| Approach | 4 Percutaneous Endoscopic |
| Device | 4 Internal Fixation Device |
| Qualifier | Z No Qualifier |
Operation Definition
Joining together portions of an articular body part rendering the articular body part immobile
Procedure Overview
Fusion procedures permanently join the bones of a joint together so it can no longer move, a technique most often applied to small joints of the wrist and fingers, or occasionally the shoulder, when arthritis, instability, or severe deformity has made the joint too painful or unreliable to preserve. By eliminating motion at that single joint, fusion is intended to relieve pain and restore stability, accepting stiffness in exchange for a more predictable, load-bearing joint.
Surgeons commonly perform fusion for advanced wrist arthritis, for a badly damaged finger joint following trauma or rheumatoid disease, or as a salvage option after a failed joint replacement. The bones are prepared, aligned, and held together with hardware such as plates, screws, wires, or a bone graft while the surfaces knit into a single solid unit over subsequent months.
Anatomy & Axis Detail
Sternoclavicular Joint, Right
The right sternoclavicular joint links the medial clavicle to the manubrium of the sternum and is the only true articulation connecting the upper limb to the axial skeleton, stabilized by strong capsular and costoclavicular ligaments and a fibrocartilaginous disc. Fusion is rarely performed here but may be indicated for chronic instability, painful degenerative arthritis, or post-traumatic dislocation that has failed conservative management, since the joint sits directly anterior to major mediastinal vessels and the trachea, making surgical intervention inherently higher risk. Surgeons must weigh this proximity carefully when selecting fixation methods, often avoiding rigid hardware that could migrate toward these structures. Documentation should confirm the joint's precise location and laterality, as sternoclavicular fusion is anatomically and functionally distinct from procedures on the adjacent acromioclavicular joint or shoulder proper.
Approach: Percutaneous Endoscopic
Percutaneous Endoscopic combines a puncture through skin or mucous membrane with insertion of an endoscope to visualize the procedure internally, as in laparoscopic cholecystectomy. It is distinguished from plain Percutaneous by the presence of scope-guided visualization, and from Via Natural or Artificial Opening Endoscopic by its route being a new puncture rather than an existing orifice or stoma.
Device: Internal Fixation Device
Internal fixation device is the general value for hardware such as plates, screws, or rods placed within the body to stabilize bone or joint, used when a more specific configuration is not indicated. It stands in contrast to the named subtypes - Rigid Plate, Intramedullary, Sustained Compression, and Intramedullary Limb Lengthening - which specify how the hardware achieves stabilization.
Coding & Documentation
The coder must identify the specific joint fused, the approach (open, percutaneous, or percutaneous endoscopic), and the device qualifier reflecting what was used to hold the joint immobile, whether internal fixation, a bone graft from the patient's own body, synthetic substitute, or a combination of graft and internal fixation. A frequent error is choosing the wrong device qualifier when both an autograft and hardware are used together, since ICD-10-PCS has a specific combination qualifier for that scenario rather than defaulting to just "internal fixation device." Another common oversight is failing to code the bone graft harvest separately when it is taken from a different, non-contiguous body part.