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Closed treatment of a humeral condylar fracture, specifically of the medial or lateral condyle, involves a non-surgical approach to address a fracture located at the distal end of the humerus. The humerus, which is the long bone of the upper arm, features two prominent projections known as the medial epicondyle and lateral epicondyle. A condylar fracture refers to a break that occurs in the area where these projections are located, leading to a separation of the medial metaphysis and epicondyle from the main body of the humerus. Such fractures can also extend into the trochlea, which is the part of the humerus that articulates with the ulna, and may involve the articular surface, impacting joint function. This procedure is indicated when there is a fracture of either the medial or lateral condyle, but not both simultaneously. Prior to the treatment, radiographs are obtained to confirm the presence of the fracture. Additionally, a neurovascular examination is conducted to assess the integrity of the nerves and blood vessels surrounding the injury site. In contrast to CPT® Code 24576, which pertains to nondisplaced fractures that do not require manipulation, CPT® Code 24577 is specifically for cases where there is a minimally displaced fracture. In this scenario, the displaced fragments are manually manipulated back into their correct anatomical position, followed by immobilization of the arm using a long arm cast to ensure proper healing.
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Closed treatment of a humeral condylar fracture, medial or lateral, is indicated for the following conditions:
The procedure for closed treatment of a humeral condylar fracture involves several key steps:
After the closed treatment procedure, the patient will typically require follow-up visits to monitor the healing process. The immobilization with the long arm cast will remain in place for a specified duration, during which the patient should avoid any activities that could stress the fracture site. Pain management may be addressed as needed, and the patient will be advised on signs of complications, such as increased pain, swelling, or changes in sensation, which should prompt immediate medical attention. Once healing is confirmed through follow-up radiographs, rehabilitation exercises may be recommended to restore range of motion and strength in the affected arm.
| Short Descr | TREAT HUMERUS FRACTURE | Medium Descr | CLTX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/MANJ | Long Descr | Closed treatment of humeral condylar fracture, medial or lateral; with manipulation | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5B - Ambulatory procedures - musculoskeletal | MUE | 1 | CCS Clinical Classification | 148 - Other fracture and dislocation procedure |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 54 | Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | FS | Split (or shared) evaluation and management visit | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) |
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