Summary & Overview
CPT 24149: Elbow Joint Excision with Contracture Release
CPT code 24149 denotes an open surgical excision of the elbow joint capsule with removal of abnormal bony growths and concurrent incision of muscle or tendon to release elbow joint contracture. Nationally, this code captures procedures aimed at restoring elbow range of motion and relieving mechanical joint impingement, often performed after trauma, chronic inflammatory conditions, or degenerative changes. Accurate coding is important for procedure classification, clinical documentation, and payer adjudication for post-traumatic and reconstructive elbow surgery.
Key payers in scope include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context explaining the procedure and typical sites of service, followed by national benchmarking considerations, common billing modifiers, and coding scenarios relevant to surgeons, coders, and compliance teams. The publication outlines typical clinical indications, typical operative setting (hospital outpatient department, inpatient OR, or ambulatory surgical center), and areas where documentation commonly affects coverage decisions.
This resource provides a focused overview of coding intent and clinical purpose for CPT code 24149, practical documentation points that influence coverage, and a summary of payer considerations and common modifier use. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 24149 describes a surgical procedure in which the provider excises the elbow joint capsule and surrounding tissues to remove abnormal bony growths and incises muscle or tendon to release a contracture of the elbow joint. This procedure is a form of joint debridement and contracture release addressing limited range of motion and mechanical obstruction in the elbow.
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Service type: Surgical — open elbow joint excision with soft-tissue release
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Typical site of service: Hospital outpatient department or inpatient operating room, or ambulatory surgical center when clinically appropriate
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Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with a history of post-traumatic elbow stiffness presents with progressive loss of flexion and extension and pain limiting activities of daily living. Imaging demonstrates heterotopic ossification and capsular contracture around the elbow joint with limited joint space and impingement from abnormal bony prominences. Conservative care including physical therapy, splinting, and corticosteroid injections has failed. The orthopedic surgeon schedules an operative release under general anesthesia. Intraoperatively the surgeon performs excision of the elbow joint capsule and surrounding pathological tissue to remove osteophytes and heterotopic bone and performs a muscle or tendon incision (contracture release) to restore range of motion. Typical workflow includes preoperative evaluation and imaging, perioperative anesthesia and monitoring, operative excision and soft-tissue release, intraoperative neurovascular protection, hemostasis and closure, and postoperative immobilization followed by early supervised rehabilitation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the work required to perform 24149 is substantially greater than typical due to complexity, extensive dissection, or unexpected findings. |