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Official Description

Osteotomy, humerus, with or without internal fixation

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

An osteotomy of the humerus involves the surgical cutting and realignment of the humeral bone, which is located in the upper arm. This procedure is typically indicated for correcting deformities such as rotational misalignments that may arise from conditions like malunion, where a bone heals improperly after a fracture, or osteogenesis imperfecta, a genetic disorder characterized by fragile bones. The specific type of osteotomy performed—whether it be transverse, wedge, sliding, right or left angle, V-osteotomy, or Z-osteotomy—depends on the nature and location of the deformity being addressed. The surgical approach begins with an incision made over the affected area of the upper arm, allowing the surgeon to dissect through the soft tissues to expose the humerus. Once the bone is accessible, the periosteum, which is the connective tissue surrounding the bone, is elevated to facilitate the procedure. The surgeon then utilizes instruments such as a drill, saw, or osteotome to create a precise cut in the bone according to the predetermined configuration necessary for correction. After the osteotomy is performed, internal fixation devices such as pins, screws, or plates may be applied to stabilize the bone fragments and maintain their anatomical alignment. In some cases, an external fixation device may also be utilized. The procedure described by CPT® Code 24400 specifically refers to a single osteotomy of the humerus, which may or may not involve the use of internal fixation to ensure proper healing and alignment of the bone post-surgery.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure of osteotomy of the humerus is indicated for various conditions that necessitate correction of bone deformities. These include:

  • Rotational Deformity - This condition may arise from malunion, where a previously fractured bone heals in an incorrect position, leading to misalignment.
  • Osteogenesis Imperfecta - A genetic disorder characterized by brittle bones, which may require surgical intervention to correct deformities resulting from the condition.

2. Procedure

The osteotomy procedure involves several critical steps to ensure successful correction of the deformity. The steps are as follows:

  • Step 1: Incision - The procedure begins with the surgeon making an incision in the upper arm directly over the site of the deformity. This incision allows access to the underlying bone and soft tissues.
  • Step 2: Dissection and Exposure - Following the incision, the surgeon carefully dissects through the soft tissues to expose the humerus. This step is crucial for visualizing the bone and surrounding structures.
  • Step 3: Elevation of the Periosteum - Once the humerus is exposed, the periosteum, which is the fibrous tissue covering the bone, is elevated. This elevation is necessary to facilitate the cutting of the bone.
  • Step 4: Bone Cutting - Using surgical instruments such as a drill, saw, or osteotome, the surgeon performs the osteotomy by cutting the bone in a specific configuration that has been predetermined based on the type of deformity.
  • Step 5: Internal Fixation - After the osteotomy is completed, the surgeon may apply internal fixation devices, such as pins, screws, or a plate and screw device, to secure the cut edges of the bone in anatomical alignment. This stabilization is essential for proper healing.
  • Step 6: Alternative Fixation - In some cases, an external fixation device may be applied instead of or in addition to internal fixation, depending on the specific requirements of the case.

3. Post-Procedure

Post-procedure care following an osteotomy of the humerus typically involves monitoring for complications, managing pain, and ensuring proper healing of the bone. Patients may be advised to limit movement of the arm to allow for adequate recovery. Follow-up appointments are essential to assess the alignment of the bone and the effectiveness of the fixation. Rehabilitation may include physical therapy to restore function and strength to the arm as healing progresses. The expected recovery time can vary based on the individual case and the extent of the procedure performed.

Short Descr REVISION OF HUMERUS
Medium Descr OSTEOTOMY HUMERUS W/WO INTERNAL FIXATION
Long Descr Osteotomy, humerus, with or without internal fixation
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 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 161 - Other OR therapeutic procedures on bone
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).
RT Right side (used to identify procedures performed on the right side of the body)
LT Left side (used to identify procedures performed on the left side of the body)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
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.
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.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
81 Minimum assistant surgeon: minimum surgical assistant services are identified by adding modifier 81 to the usual procedure number.
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).
GC This service has been performed in part by a resident under the direction of a teaching physician
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
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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Pre-1990 Added Code added.
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