Summary & Overview
CPT 24430: Humeral Osteotomy for Nonunion or Malunion
CPT code 24430 identifies a surgical osteotomy and fixation procedure used to correct nonunion or malunion deformities of the upper arm (humerus). Nationally, this code is important for orthopedic surgical billing and utilization tracking because it captures definitive operative management for failed or improperly healed humeral fractures, a condition that affects mobility and function.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical and billing overview of the procedure, typical sites of service, and the context for claims submission. The publication outlines common modifiers and payer considerations where available, and it frames the code within standard surgical care pathways.
Readers will learn how 24430 is used to document corrective humeral osteotomy with fixation, what clinical scenarios typically trigger its use, and which payers commonly adjudicate claims for this service. Data gaps are identified where input information is missing, and the summary highlights areas where payers and providers commonly focus review, such as documentation of nonunion or malunion and operative fixation details. This content is intended for national audiences including billing teams, orthopedics departments, and payer policy analysts.
Billing Code Overview
CPT code 24430 describes an operative procedure to correct a nonunion or malunion deformity of the upper arm by performing an osteotomy (cutting the improperly developed or healed bone) and achieving fixation by bringing the bone ends together. This procedure is a surgical treatment for humeral deformity resulting from failed healing or abnormal bone growth.
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Service type: Surgical osteotomy with internal fixation for nonunion or malunion of the humerus
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Typical site of service: Hospital operating room or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A 42-year-old right-hand-dominant male presents with persistent pain, deformity, and functional limitation of the mid-shaft humerus after a prior fracture that failed to heal (atrophic nonunion) following conservative management and an initial open reduction internal fixation complicated by implant failure. Imaging demonstrates a hypertrophic nonunion with malalignment and shortening of the humeral shaft. The orthopedic surgeon plans an open osteotomy and revision fixation to address the nonunion/malunion: resecting sclerotic bone ends, refreshing viable bone surfaces, shortening or realigning the humeral segments as needed, and applying internal fixation (plate and screws or intramedullary device) with possible bone grafting.
The clinical workflow includes preoperative templating and medical clearance, perioperative imaging and localization, administration of general anesthesia, performance of the osteotomy with reduction and fixation, intraoperative fluoroscopy to confirm alignment and hardware position, and postoperative pain control with follow-up radiographs to document progression to union. Typical encounter documentation should include the indication (nonunion or malunion), surgical steps (osteotomy, debridement, fixation method), implants used, estimated blood loss, any grafting or biologic adjuncts, laterality, and postoperative instructions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | Use when the procedure is performed on the left humerus |