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Official Description

Repair medial collateral ligament, elbow, with local tissue

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 24345 involves the surgical repair of the medial collateral ligament (MCL) of the elbow using local tissue. The MCL, also known as the ulnar collateral ligament, is a critical structure that stabilizes the elbow joint and is composed of three interconnected bands of tissue. These bands include the anterior band, which connects the anterior medial epicondyle of the humerus to the coronoid process of the ulna; the posterior band, which attaches to the posterior aspect of the medial humeral epicondyle and the medial edge of the ulnar olecranon process; and an intermediate band that merges with both the anterior and posterior bands. Injuries to the MCL can occur due to acute trauma, such as a fall or direct impact, or from chronic stress, often seen in athletes who perform repetitive overhead motions. The surgical repair procedure involves making an incision over the medial aspect of the elbow to access the joint capsule, followed by careful dissection to expose the MCL. The damaged ligament is then debrided, and local tissue is utilized to reinforce the repair, ensuring the stability and functionality of the elbow joint post-surgery.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 24345 is indicated for the repair of the medial collateral ligament (MCL) of the elbow, particularly in cases where there is significant injury or damage to the ligament. The following conditions may warrant this surgical intervention:

  • Acute Trauma Injury to the MCL resulting from a sudden impact or fall that compromises the integrity of the ligament.
  • Chronic Stress Repetitive strain on the elbow joint, often seen in athletes, leading to gradual deterioration of the MCL.
  • Instability of the Elbow Symptoms of instability or pain in the elbow joint that affect the patient's ability to perform daily activities or sports.

2. Procedure

The surgical procedure for the repair of the medial collateral ligament (MCL) involves several critical steps to ensure effective reconstruction and stabilization of the elbow joint. The following procedural steps are outlined:

  • Step 1: Incision An incision is made over the medial aspect of the elbow joint to provide access to the underlying structures. This incision is carefully placed to minimize damage to surrounding tissues.
  • Step 2: Dissection The tissue overlying the joint capsule is dissected to expose the MCL. During this step, care is taken to protect the neurovascular structures that are located in proximity to the elbow joint.
  • Step 3: Exposure of the MCL The joint capsule is incised to fully expose the MCL. This allows the surgeon to assess the extent of the injury and plan the repair accordingly.
  • Step 4: Release and Debridement The MCL is released from its bony attachments at the site of the injury. Damaged tissue is debrided, which involves the removal of any necrotic or unhealthy tissue to promote healing.
  • Step 5: Reinforcement Local tissue is utilized to reinforce the repair of the MCL as needed. This may involve suturing adjacent tissue to the ligament to enhance stability.
  • Step 6: Reattachment One or more drill holes are created at the bony attachment site of the MCL. The ligament is then reattached using sutures, although alternative methods such as screws or suture anchors may also be employed to secure the ligament effectively.

3. Post-Procedure

After the surgical repair of the medial collateral ligament, patients can expect a recovery period that may involve immobilization of the elbow joint to allow for proper healing. Post-procedure care typically includes pain management, physical therapy to restore range of motion and strength, and regular follow-up appointments to monitor the healing process. The duration of recovery can vary based on the extent of the injury and the individual’s overall health, but adherence to rehabilitation protocols is crucial for optimal outcomes.

Short Descr REPR ELBW MED LIGMNT W/TISSU
Medium Descr REPAIR MEDIAL COLLATERAL LIGAMENT ELBOW
Long Descr Repair medial collateral ligament, elbow, with local tissue
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 1
CCS Clinical Classification 162 - Other OR therapeutic procedures on joints
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).
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.
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)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
ET Emergency services
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)
SG Ambulatory surgical center (asc) facility service
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
Date
Action
Notes
2002-01-01 Added First appearance in code book in 2002.
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