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Official Description

Arthroplasty, radial head; with implant

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 24366 refers to an arthroplasty of the radial head, which involves the surgical replacement of the radial head with a prosthetic implant. This procedure is typically indicated for patients with significant damage or degeneration of the radial head, often due to conditions such as fractures, arthritis, or other joint disorders. The surgical approach can be lateral or posterolateral, depending on the specific case and the surgeon's preference. During the operation, an incision is made between the carpi radialis brevis and the extensor digitorum muscles to access the joint. The annular ligament, which stabilizes the radial head, is carefully exposed and freed from surrounding tissues to ensure that neurovascular structures are protected throughout the procedure. The radial head and neck are then fully exposed to allow for the removal of the damaged joint surface and the preparation of the site for the prosthetic implant. The use of a prosthetic implant aims to restore the function and integrity of the elbow joint, allowing for improved range of motion and stability post-surgery. Various techniques may be employed during the procedure to ensure optimal placement and function of the implant, ultimately enhancing the patient's recovery and quality of life.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The arthroplasty of the radial head, as described by CPT® Code 24366, is indicated for the following conditions:

  • Radial Head Fractures: Significant fractures of the radial head that cannot be adequately repaired or stabilized may necessitate replacement with a prosthetic implant.
  • Degenerative Joint Disease: Conditions such as osteoarthritis affecting the radial head can lead to pain and loss of function, warranting surgical intervention.
  • Post-Traumatic Arthritis: Arthritis that develops following an injury to the elbow joint may require arthroplasty to alleviate symptoms and restore joint function.
  • Failed Previous Surgery: Patients who have undergone prior surgical procedures on the radial head that have not yielded satisfactory results may benefit from this arthroplasty.

2. Procedure

The procedure for arthroplasty of the radial head involves several critical steps to ensure successful implantation of the prosthetic device:

  • Step 1: The surgical team begins by making an incision between the carpi radialis brevis and the extensor digitorum muscles to access the radial head. This lateral or posterolateral approach allows for optimal visualization of the joint.
  • Step 2: Once the incision is made, the annular ligament is carefully exposed and freed from surrounding structures. This step is crucial for protecting neurovascular elements during the procedure.
  • Step 3: Dissection continues until the radial head and neck are fully exposed. At this point, the deteriorated joint surface is removed, preparing the site for the prosthetic implant.
  • Step 4: An oscillating saw is utilized to divide the radial neck at the level of the tuberosity. This precise cut is essential for the proper placement of the prosthesis.
  • Step 5: The remaining bone edges of the radial surface are trimmed and leveled as necessary to ensure a stable foundation for the implant.
  • Step 6: The radius is then reamed to prepare for the placement of the radial prosthesis stem. This step involves creating a suitable cavity for the stem to fit securely.
  • Step 7: A trial component is placed and fitted to assess the range of motion and ensure proper alignment before the final prosthesis is implanted.
  • Step 8: The stem component of the permanent prosthesis is then inserted, and the distal aspect of the stem is packed with bone chips as needed to promote stability and integration.
  • Step 9: Bone cement is injected under pressure to secure the stem in place, and the stem is impacted into the shaft until the rim is properly seated on the resected surface of the radius.
  • Step 10: The cup component is attached to the stem component, completing the assembly of the prosthetic joint.
  • Step 11: Finally, the surgical team checks the range of motion and joint stability before repairing the annular ligament, reapproximating the muscles and tendons, and closing the subcutaneous tissue and skin in layers.

3. Post-Procedure

After the arthroplasty procedure, patients can expect a recovery period that may involve pain management, physical therapy, and rehabilitation to restore function and mobility. Post-operative care includes monitoring for any signs of complications, such as infection or implant failure. Patients are typically advised on activity restrictions and may require follow-up visits to assess the healing process and the performance of the prosthetic implant. The overall goal of post-procedure care is to ensure a successful recovery and to maximize the functional outcomes of the surgery.

Short Descr RECONSTRUCT HEAD OF RADIUS
Medium Descr ARTHROPLASTY RADIAL HEAD W/IMPLANT
Long Descr Arthroplasty, radial head; with implant
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 Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P3D - Major procedure, orthopedic - other
MUE 1
CCS Clinical Classification 154 - Arthroplasty other than hip or knee
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.
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.
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).
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
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
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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