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The CPT® Code 24357 refers to a percutaneous tenotomy of the elbow, specifically targeting either the lateral or medial aspect, which is commonly associated with conditions such as lateral epicondylitis, known as tennis elbow, and medial epicondylitis, referred to as golfer's elbow. Lateral epicondylitis manifests as pain on the outer side of the elbow, resulting from injury to the wrist extensors, the muscles responsible for lifting the hand. Conversely, medial epicondylitis presents as pain on the inner side of the elbow, stemming from injury to the wrist flexors, the muscles that facilitate hand movement downward. The procedure involves making a small incision over the lateral or medial epicondyle, depending on the specific condition being treated. In the case of a lateral tenotomy, the extensor carpi radialis brevis tendon, which connects the wrist extensors to the lateral epicondyle, is incised. For a medial tenotomy, the common flexor tendon, which attaches the wrist flexors to the medial epicondyle, is incised. This procedure is typically performed to alleviate pain and restore function by addressing the underlying tendon issues. It is important to note that if the tenotomy is performed in conjunction with open debridement of soft tissue and/or bone, different CPT codes, such as 24358 or 24359, should be utilized to accurately reflect the complexity of the procedure performed.
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The procedure described by CPT® Code 24357 is indicated for the treatment of specific conditions affecting the elbow, particularly:
The percutaneous tenotomy procedure involves several key steps to effectively address the affected tendons in the elbow:
After the percutaneous tenotomy procedure, patients can expect a recovery period that may involve rest and rehabilitation. Post-procedure care typically includes pain management, monitoring for any signs of infection, and following a structured physical therapy program to restore strength and mobility in the elbow. The specific recovery timeline may vary based on individual patient factors and the extent of the procedure performed. It is important for patients to adhere to their healthcare provider's instructions to ensure optimal healing and return to normal activities.
| Short Descr | REPAIR ELBOW PERC | Medium Descr | TENOTOMY ELBOW LATERAL/MEDIAL PERCUTANEOUS | Long Descr | Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfer's elbow); percutaneous | 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) | 0 - 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 | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 162 - Other OR therapeutic procedures on joints |
| 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 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. | 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.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 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 | LT | Left side (used to identify procedures performed on the left side of the body) | PN | Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital | RT | Right side (used to identify procedures performed on the right side of the body) | SG | Ambulatory surgical center (asc) facility service | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician |
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| 2011-01-01 | Changed | Short description changed. |
| 2008-01-01 | Added | First appearance in code book in 2008. |
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