Summary & Overview
CPT 24331: Elbow Tendon Transfer to Restore Elbow Flexion
CPT code 24331 denotes an orthopaedic tendon transfer procedure that repositions the flexor muscle group and transfers an extensor tendon to restore or increase elbow flexion strength. This reconstructive surgical code is used in cases where biomechanical realignment of muscles and tendons is required to improve elbow function. Nationally, it is relevant to orthopaedic surgeons, hospital surgical departments, ambulatory surgery centers, and payers that cover complex reconstructive upper-extremity procedures.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a clinical and billing-focused summary of the procedure, typical service settings, and the elements that influence coding and coverage decisions. The publication outlines benchmarks commonly tracked for surgical reconstructive codes, highlights policy considerations affecting prior authorization and medical necessity determinations, and provides clinical context on the procedure’s intent and typical surgical approach.
The content supports billing staff, coding professionals, and policy analysts by clarifying what CPT code 24331 represents, where the service is typically performed, and what stakeholders should consider when reviewing claims or coverage policies. Data not available in the input includes specific payer reimbursement rates, associated taxonomies, and ICD-10 diagnoses.
Billing Code Overview
CPT code 24331 describes a surgical procedure to restore and increase elbow flexion strength by transferring the flexor muscle group from the medial condyle of the humerus to a more proximal position on the humeral shaft above the neck of the humerus. The procedure also includes transferring the extensor tendon from the distal humerus down to the radial tuberosity just below the radial neck.
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Service type: Orthopaedic reconstructive tendon transfer to improve elbow flexion and tendon positioning
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Typical site of service: Hospital operating room or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with significant loss of elbow flexion and altered forearm supination/pronation following traumatic brachial plexus injury, distal biceps tendon rupture with chronic retraction, or failed primary tendon repair. The patient presents with weakness in elbow flexion and loss of functional ability to lift or bring the hand to the mouth. Preoperative evaluation includes history and physical exam documenting motor deficits, targeted imaging (radiographs, MRI or ultrasound of the elbow and distal humerus/radius), and electrodiagnostic testing when a nerve injury is suspected. Nonoperative measures such as physical therapy and bracing have been attempted or are not expected to restore function.
In the operating room, the surgeon performs transfer of elbow flexor muscle origins from the medial epicondyle/condyle region to a more proximal humeral shaft position to increase mechanical advantage, and simultaneously repositions/extensor tendon transfers to reattach to the radial tuberosity or adjacent structures to restore forearm function. The typical site of service is an ambulatory surgical center or hospital inpatient/same-day surgery unit depending on comorbidities, anesthesia needs, and expected recovery. Postoperative care includes immobilization, pain control, and directed rehabilitation with progressive range-of-motion and strengthening protocols over weeks to months. Follow-up visits document wound healing, range of motion, strength progression, and any complications such as infection, neurovascular injury, or tendon re-rupture.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |