How To Use CPT Code 24565

CPT code 24565 describes the closed treatment of a humeral epicondylar fracture, either medial or lateral, with manipulation. 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 24565?

CPT 24565 is used to describe the closed treatment of a fracture of an epicondyle of the humerus, which is a small bump on either side of the elbow, above the condyle. The procedure involves manipulating the fractured fragment without making an incision. The provider applies pushing or pulling force on the arm and forearm to reduce the fractured fragment and checks the alignment with imaging. A splint or brace may be applied to support the healing process.

2. Official Description

The official description of CPT code 24565 is: ‘Closed treatment of humeral epicondylar fracture, medial or lateral, with manipulation.’

3. Procedure

The procedure for CPT code 24565 involves the following steps:

1. The patient is appropriately prepped and anesthetized.
2. The provider exerts pushing or pulling force on the arm and forearm to reduce the fractured fragment.
3. The provider checks the alignment of the fractured fragment using imaging.
4. A splint or brace may be applied to support the healing process.

4. Qualifying circumstances

CPT 24565 is used for the closed treatment of a humeral epicondylar fracture, either medial or lateral, with manipulation. The procedure is performed when there is a fracture of the epicondyle, which is a small bump on either side of the elbow, above the condyle. The manipulation is done without making an incision, and the provider applies pushing or pulling force to realign the fractured fragment.

5. When to use CPT code 24565

CPT code 24565 should be used when a provider performs closed treatment of a humeral epicondylar fracture, either medial or lateral, with manipulation. This code should not be used if an incision is made during the procedure or if a different type of treatment is performed.

6. Documentation requirements

To support a claim for CPT code 24565, the provider must document the following information:

• The diagnosis of a humeral epicondylar fracture
• The need for closed treatment with manipulation
• The date of the procedure
• The specific manipulation techniques used
• The application of a splint or brace, if applicable

7. Billing guidelines

When billing for CPT code 24565, ensure that the procedure performed meets the criteria for closed treatment of a humeral epicondylar fracture with manipulation. It is important to document the necessary information and use the appropriate diagnosis code. Modifier 57, Decision for surgery, may be used if the procedure was preceded by an evaluation and management (E/M) service that resulted in a decision for surgery.

8. Historical information

CPT code 24565 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Similar codes to CPT 24565

There are several similar codes to CPT 24565 that describe different procedures for fractures and dislocations of the humerus and elbow. Some examples include:

• CPT 24500: Closed treatment of humeral shaft fracture, with manipulation
• CPT 24530: Closed treatment of supracondylar or transcondylar humeral fracture, with manipulation
• CPT 24535: Closed treatment of supracondylar or transcondylar humeral fracture, with or without intercondylar extension, with manipulation
• CPT 24538: Closed treatment of supracondylar or transcondylar humeral fracture, with or without intercondylar extension, with skeletal traction and/or with percutaneous skeletal fixation
• CPT 24685: Closed treatment of radial head or neck fracture; without manipulation

9. Examples

1. A patient presents with a lateral epicondylar fracture of the humerus. The provider performs closed treatment with manipulation and applies a splint for support.
2. A patient sustains a medial epicondylar fracture of the humerus. The provider reduces the fractured fragment through manipulation and checks the alignment with imaging.
3. A patient fractures both the medial and lateral epicondyles of the humerus. The provider performs closed treatment with manipulation for both fractures and applies a brace for stabilization.
4. A patient presents with a lateral epicondylar fracture of the humerus. The provider performs closed treatment with manipulation and applies a splint. The patient also receives an evaluation and management service prior to the procedure, resulting in a decision for surgery.
5. A patient sustains a medial epicondylar fracture of the humerus. The provider reduces the fractured fragment through manipulation and checks the alignment with imaging. The patient requires additional follow-up visits for monitoring and adjustment of the splint.