Summary & Overview
CPT 24359: Tenotomy with Debridement and Tendon Reattachment
CPT code 24359 represents a specialized surgical procedure that combines tenotomy, debridement of fibrosed tissue, and reattachment of residual tendons to relieve tendon contracture. Nationally, this code is used in hand and upper-extremity surgical practices and by facilities managing tendon contracture sequelae following trauma, chronic disease, or prior procedures. It matters because accurate coding captures the complexity of operative repair and affects billing, coverage determinations, and quality measurement for reconstructive tendon services.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of coding intent and clinical context, payer coverage considerations, and benchmarking elements relevant to procedural utilization and reimbursement. The publication also outlines service-line implications for ambulatory surgery centers and hospital operating rooms where these procedures are typically performed.
The content summarizes what the code represents, clarifies the clinical scenario it addresses, and points to issues stakeholders monitor nationally: coding accuracy, appropriate site-of-service designation, and documentation to support medical necessity. Data not available in the input is noted where applicable for deeper benchmarking details.
Billing Code Overview
CPT code 24359 describes a surgical procedure in which the provider performs a tenotomy with incision of the medial or lateral site to debride fibrosed tissue and relieve tendon contracture, followed by reattachment of the residual tendons. This procedure is aimed at releasing tendon contractures and restoring tendon continuity.
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Service type: Surgical debridement and tendon repair
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Typical site of service: Ambulatory surgery center or hospital operating room
Clinical & Coding Specifications
Clinical Context
A 54-year-old patient with a history of a prior tenotomy of the flexor hallucis longus tendon presents with progressive toe contracture, pain, and limited ambulation. Examination demonstrates a fibrosed tendon stump with recurrent contracture at the medial aspect of the prior tenotomy site. Conservative measures including physical therapy, splinting, and corticosteroid injection have failed to restore functional range of motion. The orthopedic foot and ankle surgeon schedules an open revision tenotomy with debridement of fibrosed tissue and reattachment of residual tendon fibers to relieve the contracture.
Preoperative workflow includes history and physical, informed consent for revision tendon surgery, review of prior operative reports and imaging (ultrasound or MRI showing tendon scarring), anesthesia evaluation for monitored anesthesia care or general anesthesia, and surgical planning for possible tendon graft or augmentation. Intraoperative steps include incision at the medial or lateral tenotomy site, excision of scarred/fibrotic tissue, identification of tendon ends, preparation of tendon and bone or suture anchors as indicated, and reattachment of the residual tendon. Postoperative care includes immobilization in a boot or cast, pain control, wound care, and a staged rehabilitation program coordinated with physical therapy to regain tendon glide and strength.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |