How To Use CPT Code 24545

CPT code 24545 describes the open treatment of a humeral supracondylar or transcondylar fracture without intercondylar extension, including internal fixation if performed. 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 24545?

CPT 24545 is used to describe the open treatment of a humeral supracondylar or transcondylar fracture without intercondylar extension. This procedure involves the use of internal fixation, such as plates, screws, nails, or wires, to stabilize the fracture. It is performed through an open surgical incision.

2. Official Description

The official description of CPT code 24545 is: ‘Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when performed without intercondylar extension.’

3. Procedure

The procedure for CPT code 24545 involves the following steps:

1. The patient is appropriately prepped and anesthetized.
2. The provider makes an incision in the skin over the fractured bone.
3. The provider dissects down through the subcutaneous tissue, protecting the nerves and vessels.
4. The provider retracts the muscles to gain adequate exposure of the fracture.
5. The provider adjusts the bone to reduce the fracture.
6. The provider stabilizes the fracture using internal fixation, such as plates, screws, nails, or wires.
7. The provider ascertains the alignment of the fracture using imaging.
8. The provider irrigates the area, checks for bleeding, removes any instruments, and closes the incision.
9. The provider applies a splint or brace to support the healing process.

4. Qualifying circumstances

CPT code 24545 is used for patients who have a humeral supracondylar or transcondylar fracture without intercondylar extension. The procedure is performed by a provider who is qualified to perform open surgical procedures and has the necessary skills and training to perform internal fixation. The patient must meet the criteria for surgery, and the procedure must be medically necessary.

5. When to use CPT code 24545

CPT code 24545 should be used when a patient has a humeral supracondylar or transcondylar fracture without intercondylar extension and the provider performs open treatment with internal fixation. This code should not be used if the fracture extends between the condyles or if a different treatment approach, such as closed reduction or external fixation, is used.

6. Documentation requirements

To support a claim for CPT code 24545, the provider must document the following information:

• Patient’s diagnosis of a humeral supracondylar or transcondylar fracture without intercondylar extension
• Description of the procedure performed, including the use of internal fixation
• Date of the procedure
• Start and end time of the procedure
• Details of the surgical approach, including the incision site and any additional steps taken
• Documentation of any complications or unexpected findings
• Post-operative care instructions
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 24545, ensure that the procedure meets the criteria for medical necessity and is appropriately documented. It is important to use the correct diagnosis code to support the need for the procedure. Modifier 57, Decision for surgery, may be used if the procedure was preceded by an evaluation and management (E/M) service that resulted in the decision for surgery. Additional supplies, such as casting materials, should be reported separately using the appropriate HCPCS codes.

8. Historical information

CPT code 24545 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2008, to include the option for internal or external fixation without intercondylar extension.

9. Similar codes to CPT 24545

There are several similar codes to CPT code 24545 that describe different procedures for the treatment of humeral fractures. These include:

• CPT 24546: Open treatment of humeral supracondylar or transcondylar fracture with intercondylar extension, includes internal fixation, when performed
• CPT 24560: Closed treatment of humeral supracondylar or transcondylar fracture without intercondylar extension
• CPT 24565: Closed treatment of humeral supracondylar or transcondylar fracture with intercondylar extension
• CPT 24575: Percutaneous skeletal fixation of humeral supracondylar or transcondylar fracture, includes internal fixation, when performed
• CPT 24576: Percutaneous skeletal fixation of humeral supracondylar or transcondylar fracture with intercondylar extension, includes internal fixation, when performed

9. Examples

1. A patient sustains a humeral supracondylar fracture without intercondylar extension. The provider performs an open treatment with internal fixation using plates and screws.
2. A patient presents with a transcondylar fracture of the humerus without intercondylar extension. The provider performs an open treatment with internal fixation using wires.
3. A patient fractures their humerus supracondylarly without intercondylar extension. The provider performs an open treatment with internal fixation using nails.
4. A patient has a humeral transcondylar fracture without intercondylar extension. The provider performs an open treatment with internal fixation using a combination of plates and screws.
5. A patient sustains a supracondylar fracture of the humerus without intercondylar extension. The provider performs an open treatment with internal fixation using a combination of wires and screws.
6. A patient presents with a transcondylar fracture of the humerus without intercondylar extension. The provider performs an open treatment with internal fixation using plates.
7. A patient fractures their humerus supracondylarly without intercondylar extension. The provider performs an open treatment with internal fixation using screws.