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The procedure described by CPT® Code 24342 involves the surgical reinsertion of a ruptured tendon from either the biceps or triceps muscle at their distal ends. The biceps brachii, commonly known as the biceps, is a muscle located in the upper arm that plays a crucial role in elbow flexion and forearm supination. Its distal tendon inserts at the radial tuberosity near the elbow. Conversely, the triceps brachii, referred to as the triceps, is responsible for elbow extension, with its distal tendon inserting at the olecranon of the ulna. This surgical intervention is necessary when these tendons rupture, which can occur due to trauma or excessive strain. The procedure can be performed using either a one-incision or two-incision technique, allowing the surgeon to access the ruptured tendon effectively. The one-incision technique involves making a single cut near the biceps or triceps, while the two-incision technique requires separate incisions to access both the tendon and the insertion site. The goal of the surgery is to restore the normal function of the arm by securely reattaching the tendon to its original insertion point, thereby facilitating proper healing and rehabilitation.
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The procedure described by CPT® Code 24342 is indicated for the following conditions:
The surgical procedure for reinserting a ruptured distal biceps tendon begins with the selection of either a one-incision or two-incision technique. In the one-incision approach, the surgeon makes a cut either medially or laterally to the biceps, extending down over the antecubital fossa and distally over the brachioradialis muscle in the forearm. Care is taken to identify and protect the surrounding neurovascular structures. Once the incision is made, the end of the ruptured tendon is located, retrieved, and debrided to prepare it for reattachment. The tendon is then secured to the radial tuberosity using bone anchors, ensuring a stable fixation for optimal healing.
In the two-incision technique, the procedure begins with a proximal incision made over the distal biceps tendon sheath. The tendon sheath is opened, allowing access to the end of the ruptured tendon, which is then retracted into the surgical wound. Sutures are placed through the end of the tendon to facilitate its reattachment. A second incision is made over the forearm to expose the radial tuberosity, where drill holes are created. The biceps tendon is retrieved through the distal incision, and the previously placed sutures are passed through the drill holes in the radial tuberosity and secured, ensuring a strong reattachment.
For the reinsertion of a ruptured distal triceps tendon, the procedure begins with an incision made over the distal aspect of the triceps. The surgeon dissects through the soft tissues while carefully identifying and protecting the ulnar nerve. Once the end of the tendon is located, it is retrieved and debrided. The dissection continues distally into the posterior aspect of the elbow joint, exposing the olecranon. Suture anchors are placed or holes are drilled in the olecranon to facilitate the secure attachment of the triceps tendon. After the tendon is secured to the olecranon process, the surgical wound is flushed with sterile saline, closed in layers, and a dressing is applied to promote healing.
Post-procedure care following the reinsertion of a ruptured biceps or triceps tendon includes monitoring for any signs of complications, such as infection or improper healing. Patients are typically advised to follow a rehabilitation program that may include physical therapy to restore range of motion and strength in the affected arm. The recovery process may vary depending on the extent of the injury and the surgical technique used, but patients can generally expect to gradually resume normal activities as healing progresses. Follow-up appointments are essential to assess the healing process and make any necessary adjustments to the rehabilitation plan.
| Short Descr | REPAIR OF RUPTURED TENDON | Medium Descr | RINSJ RPTD BICEPS/TRICEPS TDN DSTL W/WO TDN GRF | Long Descr | Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon graft | 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) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | 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 | 2 | CCS Clinical Classification | 160 - Other therapeutic procedures on muscles and tendons |
| 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) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | SG | Ambulatory surgical center (asc) facility service | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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. | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | TU | Special payment rate, overtime | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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