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Closed treatment of a medial or lateral epicondylar fracture of the humerus involves a non-surgical approach to manage fractures located at the bony projections known as the medial and lateral epicondyles, which are situated at the distal end of the humerus. These types of fractures are classified as extra-articular, meaning they occur outside of the joint space and involve the medial or lateral columns of the humerus. The procedure is typically indicated when there is a minimally displaced fracture, where the bone fragments have not moved significantly out of alignment. Prior to treatment, a thorough evaluation is conducted, including obtaining radiographs to confirm the presence and extent of the fracture. Additionally, a neurovascular examination is performed to assess the integrity of the nerves and blood vessels surrounding the injury site, ensuring that there are no complications that could affect the patient's recovery. In cases where manipulation is necessary, the displaced fragments are carefully repositioned to restore proper anatomical alignment, followed by immobilization of the arm using appropriate splinting techniques or casting to facilitate healing.
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The closed treatment of a humeral epicondylar fracture, whether medial or lateral, is indicated for patients presenting with the following conditions:
The procedure for closed treatment of a humeral epicondylar fracture involves several key steps:
After the closed treatment procedure, the patient will require follow-up care to monitor the healing process. The immobilization device, such as a splint or cast, should remain in place for the duration recommended by the physician, typically several weeks, depending on the severity of the fracture. Patients are advised to avoid any activities that may stress the elbow joint during the recovery period. Follow-up radiographs may be necessary to confirm proper healing and alignment of the fracture. Additionally, the physician may schedule regular check-ups to assess the patient's progress and to address any concerns that may arise during the recovery phase.
| Short Descr | TREAT HUMERUS FRACTURE | Medium Descr | CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/MANJ | Long Descr | Closed treatment of humeral epicondylar fracture, medial or lateral; with manipulation | 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) | 1 - Statutory 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 | 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 | 148 - Other fracture and dislocation procedure |
| 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). | 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). | 54 | Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number. | ET | Emergency services | 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) | RT | Right side (used to identify procedures performed on the right side of the body) |
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