Summary & Overview
CPT 24365: Excision of Distal Radius for Elbow Joint Reconstruction
CPT code 24365 denotes excision of the distal radius to reconstruct the elbow joint after trauma. As a definitive orthopedic surgical intervention, it addresses complex elbow dysfunction following fractures or joint destruction and has implications for surgical resource use, post-acute care, and rehabilitation. Nationally, use of this procedure affects inpatient and outpatient surgical volumes and informs policy on coverage for trauma-related reconstructive services. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn what CPT code 24365 represents clinically, the typical settings where the procedure is performed, and the payer landscape relevant to coverage and claims processing. The publication provides benchmarks for utilization and allowed amounts where available, highlights recent policy considerations affecting reconstructive elbow surgery, and summarizes clinical context such as indications and expected postoperative care pathways. Data not provided in the input are clearly noted where applicable.
Billing Code Overview
CPT code 24365 describes a surgical procedure in which the provider excises the end of the radius, one of the forearm bones, to reconstruct the elbow joint following a traumatic injury. This procedure is a form of elbow joint reconstruction that removes damaged distal radial bone to restore joint alignment and function.
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Service type: Surgical orthopedic reconstruction
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Typical site of service: Hospital inpatient or outpatient surgical center, depending on injury severity and perioperative care needs
Data not available in the input for modifiers, associated taxonomies, and ICD-10 diagnoses.
Clinical & Coding Specifications
Clinical Context
A 36-year-old manual laborer presents after a high-energy elbow trauma with pain, instability, and loss of forearm rotation. Imaging demonstrates an irreparable comminuted radial head fracture with joint incongruity and post-traumatic arthritic changes of the radiocapitellar articulation. The orthopedic surgeon obtains informed consent and schedules operative management under general anesthesia in an ambulatory surgery center or hospital operating room. Intraoperatively, the surgeon exposes the radial head, assesses the articular surface and capitellar cartilage, and performs an excision of the radial head (partial or complete resection of the distal radius proximal end) to reconstruct and restore elbow joint alignment and motion. Hemostasis is obtained, soft tissues are repaired, and a sterile dressing and appropriate immobilization (posterior splint or hinged elbow brace) are applied. Postoperative workflow includes PACU recovery, discharge instructions for wound care and activity restrictions, early supervised range-of-motion therapy as indicated, and outpatient follow-up with radiographs to monitor healing and elbow stability.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | When the procedure is performed on the left elbow |
RT |