Summary & Overview
CPT 24136: Radial Head/Neck Necrotic Bone Debridement
CPT code 24136 represents a focused surgical procedure to access an abscessed region of the radial head or neck and excise necrotic bone to contain or eradicate local infection. This code is used for procedures that provide source control for osteomyelitis or localized bone abscesses in the proximal radius and is clinically significant because timely, appropriate surgical management can prevent systemic spread and preserve joint function.
Key payers referenced in the national analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides an overview of clinical context, typical settings of care, and payer coverage patterns where available.
Readers will learn: the clinical intent of the code and typical service setting; common modifiers and billing considerations (listed separately); what information is available from major payers about coverage and reimbursement practices; and areas where input data were not provided. Data not available in the input are noted explicitly. This summary is intended to support coding accuracy, clinical documentation alignment, and administrative planning at a national level.
Billing Code Overview
CPT code 24136 describes a surgical procedure in which the provider enters an abscessed area of the radial head or neck and removes necrotic bone to limit spread of infection. This procedure is a form of limited debridement or partial resection of the radial head/neck aimed at source control of osteomyelitis or localized bone infection.
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Service type: Surgical debridement/partial bone resection of the radial head or neck
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Typical site of service: Operating room or ambulatory surgery center, consistent with orthopedic surgical management of upper-extremity bone infection
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting with persistent lateral elbow pain, swelling, erythema, and systemic signs of infection (fever, elevated white blood cell count) after previous elbow trauma or hematogenous spread. Imaging (plain radiographs and MRI or CT) demonstrates osteomyelitis or a localized abscess involving the radial head or radial neck with sequestrum/necrotic bone. The orthopedic surgeon evaluates and documents history, exam, and imaging, obtains informed consent, and coordinates preoperative labs and antibiotics. In the operating room under regional or general anesthesia, the provider makes a surgical approach to the radial head/neck, incises the abscess cavity, performs surgical debridement and sequestrectomy to remove necrotic bone while preserving viable articular cartilage when possible, irrigates the site, obtains intraoperative cultures, and places drains if indicated. Postoperative care includes targeted IV antibiotics guided by culture results, wound care, pain control, and outpatient follow-up with serial labs and imaging to ensure infection resolution and restoration of elbow function. Typical site of service is an hospital operating room or ambulatory surgery center. Service type is operative orthopedic debridement/sequestrectomy of the radial head/neck for focal osteomyelitis/abscess.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Provider's standard service | Use for the usual, default reporting when no unusual circumstances apply |