Summary & Overview
CPT 24576: Closed Treatment of Humeral Condyle Fracture
CPT code 24576 covers closed treatment of a fracture of a humeral condyle — a rounded projection at the distal humerus — performed without incision or manipulation. This code captures a nonoperative, closed approach to managing these specific elbow-area fractures and is used across acute and ambulatory care settings. Nationally, accurate coding for closed fracture treatment affects clinical documentation, claims processing, and aggregated utilization metrics for orthopedic trauma care.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of clinical context for humeral condyle fractures, how CPT code 24576 is used in practice, and the implications for billing and claim adjudication with major commercial and public payers. The publication addresses common billing considerations, related service settings, and benchmarking approaches where available.
This summary equips billing managers, orthopedic clinicians, and revenue-cycle professionals with the context needed to classify closed humeral condyle fracture treatment correctly, understand payer coverage scope at a national level, and locate further details on utilization benchmarks and policy updates. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 24576 describes treatment of a fracture of a condyle of the humerus performed in a closed procedure. The provider addresses a fracture of one of the rounded projections at the distal humerus without making an incision or using manipulation.
Service type: Closed treatment of humeral condyle fracture
Typical site of service: Hospital inpatient or outpatient orthopedic setting, emergency department, or ambulatory surgical center depending on clinical presentation and monitoring needs.
Clinical & Coding Specifications
Clinical Context
A 42-year-old man presents to the emergency department after a fall onto an outstretched arm while cycling. He has pain, swelling, and limited elbow motion. Radiographs demonstrate a nondisplaced fracture of the lateral condyle of the humerus. The orthopedic surgeon performs a closed treatment of the humeral condylar fracture without incision or manipulation under fluoroscopic guidance, provides immobilization in a posterior splint or cast, and arranges short-interval clinic follow-up and repeat imaging. Typical workflow steps include ED assessment, imaging (plain radiographs), orthopedic evaluation, closed management in procedure area or ED with splinting or casting, patient education, and outpatient follow-up.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | When the fractured condyle is on the left upper extremity |
RT | Right side | When the fractured condyle is on the right upper extremity
52 | Reduced services | If the provider performs a lesser service than described by the full code
59 | Distinct procedural service | To indicate a separate service or procedure not ordinarily reported together