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Closed treatment of a Monteggia type fracture dislocation at the elbow involves a specific procedure characterized by the presence of a fracture at the proximal end of the ulna accompanied by a dislocation of the radial head. This type of injury typically occurs due to trauma and requires careful manipulation to restore proper alignment. The procedure begins with obtaining radiographs, which are essential for confirming the diagnosis of the fracture and dislocation. A thorough neurovascular examination is conducted to assess the integrity of the nerves and blood vessels surrounding the injury site, ensuring that there are no additional complications. The dislocated radial head is then manually reduced, meaning it is carefully repositioned back into its correct anatomical location. If the fracture of the ulna is found to be displaced, it is also manipulated to achieve proper alignment. Following these manipulative steps, additional radiographs are taken to verify that the reduction has been successful and that the fracture dislocation is properly aligned. Finally, to stabilize the arm and promote healing, the affected limb is immobilized in a long arm cast, which helps to maintain the correct position during the recovery process.
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The closed treatment of a Monteggia type fracture dislocation at the elbow is indicated for the following conditions:
The procedure for closed treatment of a Monteggia type fracture dislocation at the elbow involves several critical steps:
Post-procedure care involves monitoring the patient for any signs of complications, ensuring that the cast remains intact, and providing instructions for care at home. Patients are typically advised to keep the cast dry and to avoid putting weight on the affected arm until cleared by a healthcare professional. Follow-up appointments are necessary to assess healing through additional radiographs and to determine when the cast can be removed. Rehabilitation exercises may be recommended after cast removal to restore range of motion and strength in the elbow joint.
| Short Descr | TREAT ELBOW FRACTURE | Medium Descr | CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MANJ | Long Descr | Closed treatment of Monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of radial head), 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) | 0 - 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 | 145 - Treatment, fracture or dislocation of radius and ulna |
| 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. | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | F2 | Left hand, third digit | 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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