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Official Description

Open treatment of humeral condylar fracture, medial or lateral, includes internal fixation, when performed

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

An open treatment of a humeral condylar fracture involves a surgical procedure aimed at correcting a fracture located at the medial or lateral condyle of the distal humerus. This type of fracture is characterized by a break that extends through the condyle, which is a rounded projection at the end of the humerus, and may also involve the trochlea, the part of the humerus that articulates with the ulna. The procedure is necessary when a fracture occurs in either the medial or lateral condyle, but not both simultaneously. The surgical approach requires an incision over the elbow to access the fracture site. During the operation, careful attention is given to the surrounding nerves, particularly the ulnar nerve, which may need to be protected or transposed to ensure it is not damaged during the procedure. The fractured bone fragments are meticulously cleaned and aligned, and internal fixation methods, such as K-wires, pins, or plates, are employed to stabilize the fracture and promote healing. This comprehensive approach ensures that the fracture is properly treated, allowing for optimal recovery and function of the elbow joint.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The open treatment of a humeral condylar fracture is indicated for specific conditions related to the fracture of the distal humerus. The following are the primary indications for this procedure:

  • Fracture of the Medial Condyle A fracture specifically located at the medial condyle of the distal humerus, which may require surgical intervention for proper alignment and stabilization.
  • Fracture of the Lateral Condyle A fracture occurring at the lateral condyle, necessitating open treatment to ensure proper healing and restoration of function.

2. Procedure

The procedure for the open treatment of a humeral condylar fracture involves several critical steps to ensure effective repair of the fracture. The following outlines the procedural steps:

  • Step 1: Incision An incision is made in the skin over the elbow to provide access to the fractured area. This incision allows the surgeon to visualize and operate on the condylar fracture directly.
  • Step 2: Nerve Identification and Protection If the medial condyle is fractured, the surgeon identifies and protects branches of the medial antebrachial cutaneous nerve and the ulnar nerve. This step is crucial to prevent nerve damage during the procedure.
  • Step 3: Ulnar Nerve Transposition (if necessary) If required, the ulnar nerve is released from the cubital tunnel, exposed, and retracted to ensure it is safeguarded during the repair of the fracture.
  • Step 4: Fracture Identification The isolated fracture in either the medial or lateral condyle is identified, allowing the surgeon to focus on the specific area that requires treatment.
  • Step 5: Debris Clearance and Irrigation The fracture surfaces are cleared of any debris, and the joint space is irrigated to ensure a clean environment for healing.
  • Step 6: Reduction and Stabilization The medial or lateral condylar fragment is reduced to its proper anatomical position and secured at a minimum of two sites to prevent rotation. This stabilization is essential for optimal healing.
  • Step 7: Internal Fixation Internal fixation methods, such as K-wires, pins, nails, screws, or plate and screw fixation, are utilized to secure larger fragments of the fracture, ensuring they remain in place during the healing process.
  • Step 8: Wound Closure and Splint Application After the fracture has been stabilized, the wound is closed, and a splint is applied to support the elbow and protect the surgical site during recovery.

3. Post-Procedure

Post-procedure care following the open treatment of a humeral condylar fracture includes monitoring for any signs of complications, such as infection or improper healing. Patients are typically advised to keep the affected arm elevated and to follow specific instructions regarding splint care. Rehabilitation may be necessary to restore range of motion and strength in the elbow joint, and follow-up appointments are essential to assess the healing process and make any necessary adjustments to the treatment plan.

Short Descr TREAT HUMERUS FRACTURE
Medium Descr OPEN TREATMENT HUMERAL CONDYLAR FRACTURE
Long Descr Open treatment of humeral condylar fracture, medial or lateral, includes internal fixation, when performed
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 148 - Other fracture and dislocation 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.
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).
55 Postoperative management only: when 1 physician or other qualified health care professional performed the postoperative management and another performed the surgical procedure, the postoperative component may be identified by adding modifier 55 to the usual procedure number.
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).
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
CR Catastrophe/disaster related
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)
SG Ambulatory surgical center (asc) facility service
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
Date
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2008-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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