How To Use CPT Code 24546

CPT code 24546 describes the open treatment of a humeral supracondylar or transcondylar fracture, including internal fixation, when performed with intercondylar extension. 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 24546?

CPT 24546 is used to describe the open treatment of a humeral supracondylar or transcondylar fracture, which involves the upper arm bone, known as the humerus. This code specifically includes internal fixation when performed with intercondylar extension. The procedure typically requires making an incision in the arm and may involve the use of hardware, such as plates and screws, to stabilize the fracture during the healing process.

2. Official Description

The official description of CPT code 24546 is: ‘Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when performed with intercondylar extension.’

3. Procedure

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, including any fragments.
6. The provider may stabilize the fracture with a plate and screws or other internal fixation.
7. The provider ascertains the alignment on imaging.
8. The provider may place a drain.
9. The provider irrigates the area, checks for bleeding, removes any instruments, and closes the incision.
10. The provider applies a splint or brace.

4. Qualifying circumstances

CPT 24546 is used for patients with a humeral supracondylar or transcondylar fracture that requires open treatment and internal fixation with intercondylar extension. The procedure is typically performed by a qualified healthcare professional and may involve the use of hardware to stabilize the fracture.

5. When to use CPT code 24546

CPT code 24546 should be used when a patient requires open treatment of a humeral supracondylar or transcondylar fracture, including internal fixation with intercondylar extension. It is important to ensure that the procedure performed aligns with the specific details outlined in the code description.

6. Documentation requirements

To support a claim for CPT 24546, the healthcare professional must document the following information:

• Patient’s diagnosis of a humeral supracondylar or transcondylar fracture
• Details of the procedure performed, including the use of internal fixation with intercondylar extension
• Date of the procedure
• Incision site and length
• Specific steps taken during the procedure, such as reduction of the fracture and placement of hardware
• Any additional procedures performed, such as the placement of a drain
• Post-procedure care instructions
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT 24546, ensure that the procedure performed aligns with the specific details outlined in the code description. It is important to accurately document the procedure and any additional services provided. Modifier 57, Decision for surgery, may be used if an evaluation and management (E/M) service resulted in the decision for surgery. Additionally, be aware of any additional supplies or services that may need to be reported separately.

8. Historical information

CPT 24546 was added to the Current Procedural Terminology system on January 1, 1993. On January 1, 2008, the code description was updated to include the option of internal or external fixation with intercondylar extension.

9. Examples

1. A patient undergoes open treatment of a humeral supracondylar fracture with internal fixation using plates and screws, with intercondylar extension.
2. A provider performs open treatment of a humeral transcondylar fracture with internal fixation using a nail, with intercondylar extension.
3. A patient requires open treatment of a humeral supracondylar fracture with internal fixation using wires, with intercondylar extension.
4. A provider performs open treatment of a humeral transcondylar fracture with internal fixation using a combination of plates and screws, with intercondylar extension.
5. A patient undergoes open treatment of a humeral supracondylar fracture with internal fixation using an intramedullary rod, with intercondylar extension.
6. A provider performs open treatment of a humeral transcondylar fracture with internal fixation using a combination of wires and screws, with intercondylar extension.
7. A patient requires open treatment of a humeral supracondylar fracture with internal fixation using a plate, with intercondylar extension.
8. A provider performs open treatment of a humeral transcondylar fracture with internal fixation using screws, with intercondylar extension.
9. A patient undergoes open treatment of a humeral supracondylar fracture with internal fixation using a combination of plates, screws, and wires, with intercondylar extension.
10. A provider performs open treatment of a humeral transcondylar fracture with internal fixation using a combination of nails and screws, with intercondylar extension.