Summary & Overview
CPT 24345: Elbow Medial Collateral Ligament Repair, Local Tissue
CPT code 24345 represents surgical repair of the medial collateral ligament (MCL) of the elbow using local tissue. This procedure is an important part of orthopedic trauma and sports-medicine care when primary repair is possible, impacting surgical utilization, perioperative care patterns, and payment for upper-extremity ligament reconstructions nationwide. The code is relevant across both commercial and public payers and affects facility and professional claims in hospital and ambulatory surgery settings.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, standard sites of service, and commonly observed claim modifiers and billing considerations. The publication provides benchmarks and comparative information on coding and service lines, notes typical payer coverage scope, and outlines areas where policy updates or coding clarifications commonly arise. Clinical implications covered include indications for primary repair versus reconstruction and expected care settings. Operational guidance focuses on claim composition and common payer interactions rather than clinical decision-making.
Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, and related codes.
Billing Code Overview
CPT code 24345 describes a surgical procedure to repair a damaged or injured medial collateral ligament (MCL) of the elbow using local tissue. The procedure involves direct repair of the MCL, typically indicated when the ligament is torn or disrupted and local tissue is suitable for reconstruction.
Service Type: Surgical — Orthopedic Elbow Ligament Repair
Typical Site of Service: Hospital operating room or ambulatory surgery center
Clinical & Coding Specifications
Clinical Context
A 38-year-old recreational softball player presents with medial elbow pain and instability after a valgus stress injury sustained while throwing. Examination demonstrates tenderness over the medial epicondyle, pain with valgus stress testing, and decreased grip strength. Imaging (MRI) confirms a partial tear of the medial collateral ligament (MCL) of the elbow with local tissue retraction but preserved adjacent soft tissue suitable for primary repair. The patient is scheduled for operative repair of the MCL using local autologous tissue under regional or general anesthesia.
The clinical workflow includes preoperative evaluation with history and physical, review of MRI and plain radiographs to exclude fracture or ossicles, informed consent, preoperative medical optimization, operating room procedure where the elbow is exposed via a medial incision, identification of the torn MCL, repair using local tissue (suture anchors or direct repair to origin/footprint), intraoperative stability testing, wound closure, and postoperative immobilization. Postoperative care includes pain management, wound checks, graduated physical therapy with protected range of motion, and progressive strengthening over several months with return-to-throw protocols when stability and strength are restored.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — primary reporting | Used when no standard modifier is applicable and the service is reported normally. |