How To Use CPT Code 24365

CPT code 24365 describes the procedure of arthroplasty, specifically the reconstruction of the radial head in the elbow joint after a traumatic injury. 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 24365?

CPT 24365 is used to describe the surgical procedure of arthroplasty, specifically the reconstruction of the radial head in the elbow joint. This procedure is performed when a patient has experienced a traumatic injury that has resulted in damage to the radial head. The provider will excise the end of the radius and reconstruct the elbow joint to restore function and alleviate pain.

2. Official Description

The official description of CPT code 24365 is: ‘Arthroplasty, radial head.’

3. Procedure

1. The patient is appropriately prepped and anesthetized for the procedure.
2. The provider makes an incision on the side of the elbow joint to access the radial head.
3. The provider dissects through the subcutaneous tissue, ensuring the nerves and blood vessels are not damaged.
4. The joint capsule is incised, and the radial head is exposed.
5. The provider excises the damaged radial head using a bone cutting instrument.
6. The provider realigns the elbow joint and sutures the soft tissue in layers.
7. The wound is closed, and a drain may be left in place.

4. Qualifying circumstances

CPT 24365 is performed when a patient has experienced a traumatic injury resulting in damage to the radial head in the elbow joint. This procedure is typically reserved for cases where conservative treatments have failed to alleviate pain and restore function. The patient must meet the specific criteria for the procedure, as determined by the provider.

5. When to use CPT code 24365

CPT code 24365 should be used when a provider performs arthroplasty to reconstruct the radial head in the elbow joint. This code is appropriate for cases involving traumatic injuries that have resulted in damage to the radial head. It is important to ensure that the documentation supports the necessity and appropriateness of the procedure.

6. Documentation requirements

To support a claim for CPT 24365, the provider must document the following information:

• Patient’s diagnosis and the indication for the procedure
• Description of the procedure performed, including the specific steps taken
• Details of any complications or unexpected findings
• Any additional procedures performed during the same operative session
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 24365, it is important to ensure that the documentation supports the necessity and appropriateness of the procedure. The provider should use the appropriate CPT code based on the specific procedure performed. It is also important to follow any specific billing guidelines provided by the payer or insurance company.

8. Historical information

CPT 24365 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient sustains a traumatic injury to the elbow, resulting in a fractured radial head. The provider performs arthroplasty to reconstruct the radial head and restore function to the joint.
2. A patient presents with chronic pain and limited range of motion in the elbow joint due to a previous traumatic injury. The provider determines that arthroplasty of the radial head is necessary to alleviate pain and improve function.
3. A patient undergoes arthroplasty of the radial head following a failed attempt at conservative treatment for a traumatic injury to the elbow joint.
4. A patient with a history of recurrent dislocations of the elbow joint undergoes arthroplasty of the radial head to stabilize the joint and prevent further dislocations.
5. A patient experiences persistent pain and instability in the elbow joint following a traumatic injury. The provider performs arthroplasty of the radial head to address the underlying cause of the symptoms.
6. A patient presents with limited range of motion and functional impairment in the elbow joint due to a previous traumatic injury. The provider determines that arthroplasty of the radial head is necessary to restore function and improve quality of life.
7. A patient undergoes arthroplasty of the radial head following a failed attempt at conservative treatment for a traumatic injury to the elbow joint.
8. A patient with a history of recurrent dislocations of the elbow joint undergoes arthroplasty of the radial head to stabilize the joint and prevent further dislocations.
9. A patient experiences persistent pain and instability in the elbow joint following a traumatic injury. The provider performs arthroplasty of the radial head to address the underlying cause of the symptoms.
10. A patient presents with limited range of motion and functional impairment in the elbow joint due to a previous traumatic injury. The provider determines that arthroplasty of the radial head is necessary to restore function and improve quality of life.