How To Use CPT Code 24149

CPT code 24149 describes the radical resection of the elbow joint capsule, soft tissue, and heterotopic bone, with contracture release. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 24149?

CPT 24149 is a code used to describe the radical resection of the elbow joint capsule, soft tissue, and heterotopic bone, with contracture release. This procedure involves the excision of the elbow joint capsule and surrounding tissues to remove any abnormal bony growth. It also includes the incision of muscle or tendon to release the contracture of the elbow joint.

2. Official Description

The official description of CPT code 24149 is: ‘Radical resection of capsule, soft tissue, and heterotopic bone, elbow, with contracture release (separate procedure).’

3. Procedure

During the procedure, the healthcare provider makes an incision deep down to the level of the elbow joint capsule. They then resect the capsule radically to open up the joint for extensive debridement or resection of abnormal overgrowth of bone, known as heterotopic ossification. Additionally, any soft tissue over the joint is removed, and an incision is made on the muscles or tendon to release the contracture. In cases of excessive bone growth or extensive release, multiple incisions may be made. After confirming the full range of motion of the joint, the provider irrigates the joint and closes the incisions in layers.

4. Qualifying circumstances

CPT 24149 is performed on patients who have abnormal bony growth, known as heterotopic bone, in the elbow joint. This procedure is indicated when there is a contracture of the elbow joint, which is the permanent tightening of non-bony tissues such as muscles, tendons, and ligaments. The patient must meet the criteria for the procedure, and the healthcare provider must determine that the radical resection of the capsule, soft tissue, and heterotopic bone, with contracture release, is necessary.

5. When to use CPT code 24149

CPT code 24149 should be used when the healthcare provider performs a radical resection of the elbow joint capsule, soft tissue, and heterotopic bone, with contracture release, as a separate procedure. It is important to note that this code should not be reported separately if the procedure is performed with a more extensive procedure done on the same site.

6. Documentation requirements

To support a claim for CPT 24149, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for radical resection of the elbow joint capsule, soft tissue, and heterotopic bone, with contracture release
• Details of the procedure performed, including the incisions made, resection of the capsule and soft tissue, removal of heterotopic bone, and contracture release
• Date of the procedure
• Confirmation of the full range of motion of the joint
• Details of any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 24149, ensure that the procedure meets the criteria for radical resection of the elbow joint capsule, soft tissue, and heterotopic bone, with contracture release. It is important to note that this code should not be reported separately if the procedure is performed with a more extensive procedure done on the same site. Additional tips for billing CPT 24149 may include considering the location of the testing, which plays a part in how you code these procedures.

8. Historical information

CPT 24149 was added to the Current Procedural Terminology system on January 1, 1997. There have been no updates to the code since its addition.

9. Similar codes to CPT 24149

There are several similar codes to CPT 24149 that describe excision procedures on the humerus (upper arm) and elbow. These codes include:

• CPT 24065: Excision of elbow joint capsule
• CPT 24066: Excision of elbow joint capsule with synovectomy
• CPT 24075: Excision of elbow joint capsule with release of contracture
• CPT 24145: Excision of elbow joint capsule with extensive debridement
• CPT 24155: Excision of elbow joint capsule with extensive debridement and synovectomy

9. Examples

1. A patient with heterotopic bone growth in the elbow joint undergoes a radical resection of the capsule, soft tissue, and heterotopic bone, with contracture release.
2. A healthcare provider performs a separate procedure to excise the elbow joint capsule, soft tissue, and heterotopic bone and release the contracture in a patient with a contracture of the elbow joint.
3. A patient with limited range of motion in the elbow joint undergoes a radical resection of the capsule, soft tissue, and heterotopic bone, with contracture release to improve mobility.
4. A healthcare provider performs a separate procedure to remove abnormal bony growth and release the contracture in a patient with a contracture of the elbow joint.
5. A patient with heterotopic ossification in the elbow joint undergoes a radical resection of the capsule, soft tissue, and heterotopic bone, with contracture release to alleviate symptoms and improve function.
6. A healthcare provider performs a separate procedure to excise the elbow joint capsule, soft tissue, and heterotopic bone and release the contracture in a patient with limited mobility in the elbow joint.
7. A patient with a contracture of the elbow joint undergoes a radical resection of the capsule, soft tissue, and heterotopic bone, with contracture release to restore range of motion.
8. A healthcare provider performs a separate procedure to remove abnormal bony growth and release the contracture in a patient with restricted movement in the elbow joint.
9. A patient with heterotopic bone in the elbow joint undergoes a radical resection of the capsule, soft tissue, and heterotopic bone, with contracture release to improve joint function.