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The CPT® Code 24370 refers to the procedure known as the revision of total elbow arthroplasty, which may include the use of allograft tissue when performed. This surgical intervention is typically indicated for patients experiencing complications such as component loosening, joint instability, infection, or periprosthetic fractures that necessitate the replacement or adjustment of the elbow joint components. During the procedure, the surgeon reopens the previous incision over the elbow joint to access the underlying structures. The ulnar nerve is carefully identified and protected to prevent injury during the operation. The procedure involves the exposure of the ulnar component, followed by the removal of any loose bone cement that may be compromising the stability of the implant. The radial nerve is also identified and safeguarded as the humeral component is exposed and evaluated. If necessary, the surgeon may debride any infected or necrotic bone and tissue. Depending on the condition of the existing components, they may be replaced with new implants or repositioned to restore proper function. The final steps involve securing the components in place using allograft bone, cerclage wires, and/or bone cement, followed by the reattachment of ligaments and tendons, and the closure of the incision in layers. This procedure is crucial for restoring the functionality of the elbow joint and alleviating pain associated with the aforementioned complications.
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The revision of total elbow arthroplasty, as described by CPT® Code 24370, is indicated for several specific conditions that may arise post-operatively. These include:
The procedure for the revision of total elbow arthroplasty involves several critical steps, which are detailed as follows:
After the revision of total elbow arthroplasty, patients can expect a recovery period that may involve pain management, physical therapy, and regular follow-up appointments to monitor healing. The arm will typically be immobilized in a splint to allow for proper healing of the surgical site and stabilization of the newly positioned or replaced components. Patients should be advised on activity restrictions and signs of complications, such as increased pain, swelling, or signs of infection, which should be reported to their healthcare provider promptly. The overall goal of the procedure is to restore function and alleviate pain associated with the previous elbow joint issues.
| Short Descr | REVISE RECONST ELBOW JOINT | Medium Descr | REVIS ELBOW ARTHRPLSTY HUMERAL/ULNA COMPNT | Long Descr | Revision of total elbow arthroplasty, including allograft when performed; humeral or ulnar component | 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) | 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 | 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 |
This is a primary code that can be used with these additional add-on codes.
| 20704 | Add-on Code MPFS Status: Active Code APC N Manual preparation and insertion of drug-delivery device(s), intra-articular (List separately in addition to code for primary procedure) | 20705 | Add-on Code MPFS Status: Active Code APC N Removal of drug-delivery device(s), intra-articular (List separately in addition to code for primary procedure) |
| 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. | 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). | 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. | 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) |
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| 2013-01-01 | Added | Added |
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