How To Use CPT Code 24566

CPT code 24566 describes the percutaneous skeletal fixation 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 24566?

CPT 24566 is used to describe the percutaneous skeletal fixation of a humeral epicondylar fracture, either medial or lateral, with manipulation. This code is used when a healthcare provider performs a procedure to realign the fracture and inserts pins or wires through the skin into the bone to hold the fracture in place.

2. Official Description

The official description of CPT code 24566 is: ‘Percutaneous skeletal fixation of humeral epicondylar fracture, medial or lateral, with manipulation.’

3. Procedure

During the procedure for CPT 24566, the healthcare provider first assesses the fracture and determines the need for percutaneous skeletal fixation. The patient is appropriately prepped and anesthetized, and fluoroscopic guidance may be used. The provider then manipulates the fracture to realign it. Pins or wires are inserted through the skin and into the bone, using a drill, to stabilize the fracture. The wounds are dressed, and a splint or brace is applied to immobilize the arm.

4. Qualifying circumstances

CPT 24566 is used for patients with a humeral epicondylar fracture, either medial or lateral, that requires percutaneous skeletal fixation with manipulation. The procedure is performed by a healthcare provider who is appropriately trained and qualified to perform the procedure. The patient must meet the criteria for the specific fracture and the need for percutaneous skeletal fixation.

5. When to use CPT code 24566

CPT code 24566 should be used when a healthcare provider performs percutaneous skeletal fixation of a humeral epicondylar fracture, either medial or lateral, with manipulation. This code should not be used for fractures in other locations or for different types of procedures.

6. Documentation requirements

To support a claim for CPT 24566, the healthcare provider must document the following information:

• Diagnosis of the humeral epicondylar fracture
• Documentation of the need for percutaneous skeletal fixation with manipulation
• Description of the procedure performed, including any use of fluoroscopic guidance
• Date of the procedure
• Details of the pins or wires inserted, including the number and location
• Description of any additional procedures performed, such as wound dressing or application of a splint or brace
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 24566, ensure that the procedure meets the criteria for percutaneous skeletal fixation of a humeral epicondylar fracture, either medial or lateral, with manipulation. It is important to follow the specific documentation requirements and guidelines provided by the payer. Additionally, be aware of any modifiers that may be required or any bundling or unbundling rules that apply to this code.

8. Historical information

CPT 24566 was added to the Current Procedural Terminology system on January 1, 1994. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient presents with a medial humeral epicondylar fracture, and the healthcare provider performs percutaneous skeletal fixation with manipulation using CPT code 24566.
2. A patient sustains a lateral humeral epicondylar fracture, and the healthcare provider performs percutaneous skeletal fixation with manipulation using CPT code 24566.
3. A healthcare provider performs percutaneous skeletal fixation with manipulation for a medial humeral epicondylar fracture in a patient who has previously undergone a failed non-surgical treatment.
4. A patient with a lateral humeral epicondylar fracture undergoes percutaneous skeletal fixation with manipulation as a primary treatment option.
5. A healthcare provider performs percutaneous skeletal fixation with manipulation for a medial humeral epicondylar fracture in a patient with multiple comorbidities.
6. A patient presents with a lateral humeral epicondylar fracture, and the healthcare provider performs percutaneous skeletal fixation with manipulation using CPT code 24566 as part of a multi-disciplinary approach to treatment.
7. A healthcare provider performs percutaneous skeletal fixation with manipulation for a medial humeral epicondylar fracture in a pediatric patient.
8. A patient with a lateral humeral epicondylar fracture undergoes percutaneous skeletal fixation with manipulation as a revision procedure following a failed initial surgery.
9. A healthcare provider performs percutaneous skeletal fixation with manipulation for a medial humeral epicondylar fracture in an elderly patient with osteoporosis.
10. A patient presents with a lateral humeral epicondylar fracture, and the healthcare provider performs percutaneous skeletal fixation with manipulation using CPT code 24566 as an outpatient procedure.