How To Use CPT Code 24586

CPT code 24586 describes the open treatment of periarticular fracture and/or dislocation of the elbow, specifically involving the fracture of the distal humerus and proximal ulna and/or proximal radius. 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 24586?

CPT 24586 is a code used to describe the open treatment of periarticular fracture and/or dislocation of the elbow. This procedure involves the surgical repair of fractures or displacement of the bones in the elbow joint, upper arm bone (humerus), and one or both of the lower arm bones (radius and ulna). The provider makes one or more incisions over the elbow to access and repair the fracture or dislocation.

2. Official Description

The official description of CPT code 24586 is: ‘Open treatment of periarticular fracture and/or dislocation of the elbow (fracture distal humerus and proximal ulna and/or proximal radius).’ This code specifically refers to the surgical treatment of fractures and dislocations involving the distal humerus, proximal ulna, and/or proximal radius in the elbow joint.

3. Procedure

When performing the open treatment of periarticular fracture and/or dislocation of the elbow (CPT 24586), the provider follows a specific procedure:

1. The patient is appropriately prepped and anesthetized.
2. The provider makes a lateral incision over the fracture site.
3. Subcutaneous tissue and muscle are dissected to expose the bone.
4. If there is a dislocation, the provider returns the bone to its proper location in the joint.
5. If necessary, the provider accesses the fracture through a second incision.
6. The provider reduces the fragments of the fracture.
7. Plate and screws, pins, or wires may be applied to hold the reduction in place.
8. The area is irrigated, checked for bleeding, and any instruments are removed.
9. The incision is closed, and a splint or brace may be applied.

4. Qualifying circumstances

CPT 24586 is used for patients who require open treatment of periarticular fracture and/or dislocation of the elbow. This code applies to fractures and dislocations involving the distal humerus, proximal ulna, and/or proximal radius. The procedure is performed by a qualified healthcare professional and requires surgical intervention.

5. When to use CPT code 24586

CPT code 24586 should be used when the provider performs open treatment for periarticular fracture and/or dislocation of the elbow. This code is appropriate when the specific bones involved are the distal humerus, proximal ulna, and/or proximal radius. It is important to ensure that the documentation supports the use of this code and accurately describes the procedure performed.

6. Documentation requirements

To support a claim for CPT code 24586, the provider must document the following information:

• Patient’s diagnosis of periarticular fracture and/or dislocation of the elbow
• Details of the surgical procedure performed, including the specific bones involved
• Incision sites and approach used
• Description of reduction techniques and fixation methods used
• Any additional procedures performed during the surgery
• Post-operative care instructions
• Signature of the performing provider

7. Billing guidelines

When billing for CPT code 24586, ensure that the documentation supports the use of this specific code for the open treatment of periarticular fracture and/or dislocation of the elbow. It is important to follow the appropriate coding guidelines and modifiers, if applicable. Additionally, be aware of any bundling or unbundling issues and ensure accurate and complete documentation to support the services provided.

8. Historical information

CPT code 24586 was added to the Current Procedural Terminology system on January 1, 1990. There have been several code changes since its addition, with the most recent change occurring on January 1, 2010.

9. Similar codes to CPT 24586

There are several similar codes to CPT code 24586 that describe other procedures for fractures and dislocations of the elbow. Some similar codes include:

• CPT 24575: Open treatment of radial head or neck fracture
• CPT 24576: Open treatment of radial head or neck fracture with internal fixation
• CPT 24577: Open treatment of radial head or neck fracture with prosthetic replacement
• CPT 24579: Open treatment of radial head or neck fracture with internal fixation and prosthetic replacement
• CPT 24586: Open treatment of periarticular fracture and/or dislocation of the elbow (fracture distal humerus and proximal ulna and/or proximal radius)

9. Examples

1. A patient sustains a fracture involving the distal humerus, proximal ulna, and proximal radius in the elbow joint. The provider performs open treatment of the periarticular fracture, reducing the fragments and applying internal fixation.
2. A patient presents with a dislocation of the elbow joint, specifically involving the distal humerus, proximal ulna, and proximal radius. The provider performs open treatment, reducing the dislocation and applying a prosthetic replacement.
3. A patient experiences a periarticular fracture and dislocation of the elbow, involving the distal humerus and proximal ulna. The provider performs open treatment, reducing the fracture and dislocation, and applies both internal fixation and prosthetic replacement.