Summary & Overview
CPT 24358: Tenotomy Site Incision and Debridement for Tendon Contracture
CPT code 24358 designates a surgical procedure that incises the medial or lateral site of a tenotomy to debride fibrosed tissue and relieve tendon contracture. Nationally, this code is used to classify targeted surgical management of tendon fibrosis and contracture that limit function and can contribute to pain and disability. Accurate coding supports clinical communication, surgical quality tracking, and appropriate claims adjudication.
Key payers reviewed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage and payment practices vary across commercial plans and Medicare policies; understanding typical sites of service and clinical documentation requirements is essential for consistent reimbursement and audit readiness.
Readers will find clinical context for when the procedure is reported, typical sites of service, and what documentation supports coding this service. The publication also provides benchmarking insights and policy updates relevant to national payers, highlights coding nuances for surgical tendon procedures, and summarizes common modifiers and coding considerations. Where specific input data are missing, the text notes the absence rather than extrapolating details.
Billing Code Overview
CPT code 24358 describes a surgical procedure in which the provider makes an incision at the medial or lateral site of a tenotomy to debride fibrosed tissue and relieve tendon contracture. This is a surgical debridement of fibrosed tendon tissue performed to restore tendon mobility and reduce contracture-related impairment.
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Service type: Surgical procedure (tenotomy site incision with debridement)
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Typical site of service: Ambulatory surgical center or hospital operating room, depending on clinical complexity and patient needs.
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Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with a longstanding flexion contracture of the finger tendon presents with progressive loss of extension and pain at the site of prior tenotomy. Conservative care including splinting, therapy, and steroid injection provided limited benefit. The surgeon evaluates the affected digit in an outpatient minor procedure suite or ambulatory surgery center and elects to perform debridement of fibrosed tissue at the medial or lateral site of the prior tenotomy to relieve tendon contracture. The workflow includes preoperative consent and targeted local or regional anesthesia, operative site preparation, limited incision at the previous tenotomy site, excision of fibrotic tissue surrounding the tendon, assessment of tendon gliding, hemostasis, and layered closure. Postprocedure care includes dressing, instructions for wound care, pain control, early range-of-motion exercises or referral to hand therapy, and follow-up evaluation to monitor healing and functional improvement.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, Separately Identifiable Evaluation and Management Service | Use when a distinct E/M visit is performed on the same day as the procedure and is above and beyond typical pre- and post-procedure care. |
59 |