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Official Description

Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process[es]); with manipulation

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 24675 refers to the closed treatment of a fracture at the proximal end of the ulna, specifically when manipulation is involved. The ulna is one of the two long bones in the forearm, located on the medial side, opposite the radius. The proximal end of the ulna includes critical anatomical features such as the olecranon and the coronoid process. The olecranon is the prominent bony structure at the back of the elbow, while the coronoid process is the anterior projection that plays a vital role in the elbow joint's articulation with the humerus. This procedure is indicated for fractures that may be minimally displaced, where the bone fragments have shifted but can be realigned through manual manipulation. The treatment involves evaluating the fracture, which is typically confirmed through separately reportable X-rays. Following the manipulation, the fracture is immobilized using a sling or splint to ensure proper healing. It is important to note that this code is specifically used when manipulation is necessary, distinguishing it from other codes that may apply to closed treatments without manipulation, such as CPT® Code 24670.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The closed treatment of an ulnar fracture at the proximal end with manipulation, as described by CPT® Code 24675, is indicated for specific conditions and symptoms, including:

  • Minimally Displaced Fracture A fracture where the bone fragments are slightly out of alignment but can be realigned through manipulation.
  • Fracture of the Olecranon A fracture involving the olecranon, which is the bony prominence at the back of the elbow.
  • Fracture of the Coronoid Process A fracture affecting the coronoid process, the anterior projection of the ulna that contributes to elbow stability.
  • Evaluation of Nondisplaced Fractures Assessment of fractures that are not displaced, which may require monitoring and potential manipulation if displacement occurs.

2. Procedure

The procedure for closed treatment of an ulnar fracture with manipulation involves several key steps:

  • Step 1: Evaluation of the Fracture The initial step involves a thorough evaluation of the fracture, which includes obtaining a detailed medical history and performing a physical examination to assess the extent of the injury. This evaluation is crucial for determining the appropriate treatment plan.
  • Step 2: Imaging Studies Following the evaluation, separately reportable X-rays are obtained to visualize the fracture. These imaging studies help in assessing the alignment of the bone fragments and determining the need for manipulation.
  • Step 3: Manual Reduction If the fracture is determined to be minimally displaced, the next step is manual reduction. This involves the physician applying controlled force to realign the displaced bone fragments back to their proper anatomical position. The manipulation is performed carefully to minimize further injury.
  • Step 4: Verification of Alignment After manipulation, additional X-rays are taken to verify that the bone fragments are correctly aligned. This step is essential to ensure that the manipulation was successful and that the fracture is in the optimal position for healing.
  • Step 5: Immobilization Once proper alignment is confirmed, the final step is to immobilize the fracture. This is typically achieved using a sling or splint, which helps to stabilize the area and prevent movement that could disrupt the healing process.

3. Post-Procedure

After the closed treatment of the ulnar fracture with manipulation, the patient will require specific post-procedure care. This includes monitoring for any signs of complications, such as increased pain, swelling, or changes in circulation. The immobilization device, whether a sling or splint, should be kept in place for the duration recommended by the physician to ensure proper healing. Follow-up appointments are necessary to assess the healing process, which may involve additional imaging studies to confirm that the fracture is healing correctly. Patients are typically advised on activity restrictions and rehabilitation exercises to restore function once healing has progressed.

Short Descr TREAT ULNAR FRACTURE
Medium Descr CLOSED TX ULNAR FRACTURE PROXIMAL END W/MANJ
Long Descr Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process[es]); 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 145 - Treatment, fracture or dislocation of radius and ulna
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).
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.
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.)
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
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)
PO Excepted service provided at an off-campus, outpatient, provider-based department of a hospital
RT Right side (used to identify procedures performed on the right side of the body)
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
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
Action
Notes
2013-01-01 Changed Medium Descriptor changed.
2008-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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