Summary & Overview
CPT 24495: Forearm Compartment Fasciotomy with Brachial Artery Assessment
CPT code 24495 designates a surgical fasciotomy of a membrane-enclosed compartment in the forearm, undertaken to relieve compartment syndrome and restore perfusion, with intraoperative assessment of the brachial artery for injury. This procedure is clinically urgent and can be limb-saving after acute trauma or postoperative complications that raise intracompartmental pressure. Nationally, accurate reporting of 24495 matters for clinical documentation, resource allocation in emergency and surgical settings, and appropriate coverage determinations for acute upper-extremity care.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for 24495, the typical service setting, and the kinds of documentation elements payers commonly require for payment review. The publication outlines benchmarks and billing considerations relevant to acute surgical care, highlights common coding pitfalls for forearm compartment procedures, and summarizes policy and coverage themes that affect reimbursement and utilization review for urgent fasciotomy services. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 24495 describes a surgical procedure to relieve compartment syndrome in the forearm by incising the fascia of a membrane-enclosed compartment. The provider performs fasciotomy of the forearm compartment and examines the brachial artery for signs of injury to restore perfusion after an injury or surgery.
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Service type: Surgical decompression (fasciotomy) of the forearm compartment to relieve pressure and increase blood flow.
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Typical site of service: Operating room or emergency department procedural area where surgical intervention is performed on the upper extremity.
Clinical & Coding Specifications
Clinical Context
A middle-aged adult presents to the emergency department after a closed forearm fracture from a fall onto an outstretched hand. The patient has escalating forearm pain out of proportion to exam, tense swelling, pain with passive stretch of the fingers, paresthesia in the median nerve distribution, and diminished distal pulses. Exam and compartment pressure measurement confirm acute compartment syndrome of the forearm. The surgical team performs an urgent fasciotomy under appropriate anesthesia. The provider incises the fascia of the affected forearm compartments to decompress the compartments, restores perfusion, and inspects the brachial artery and surrounding neurovascular structures for injury. Hemostasis is achieved, wounds are managed with delayed primary closure or negative-pressure wound therapy, and the patient is admitted for postoperative monitoring, serial neurovascular checks, and wound care. Typical workflow includes preoperative consent, anesthesia evaluation (often regional block or general anesthesia), intraoperative fasciotomy with possible irrigation and debridement, vascular assessment, and postoperative critical limb monitoring and rehabilitation planning.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work or time substantially exceeds usual for 24495, with documentation of increased complexity, e.g., extensive debridement or difficult exposure. |