Summary & Overview
CPT 24586: Open Repair of Elbow Fracture or Dislocation
CPT code 24586 denotes an open operative repair for fractures or dislocations of the elbow joint, addressing injuries to the distal humerus and proximal radius and/or ulna through one or more incisions. This surgical procedure is clinically significant due to its role in restoring joint alignment, stability, and function after traumatic elbow injuries, which can have substantial implications for patient mobility and rehabilitation. Nationally, utilization of open elbow fracture repair influences hospital surgical volumes, orthopedic specialty care demand, and post-acute rehabilitation services. Key payers referenced in typical analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise clinical and billing overview of the procedure, typical settings of care, common modifiers and coding context (where available), and considerations relevant to payer coverage and claims processing. The publication covers benchmark metrics used in reimbursement review, common documentation elements required for claim adjudication, and the clinical context that supports medical necessity for operative repair versus nonoperative management. Data not provided in the input — such as specific ICD-10 pairings, payer-specific policy details, and utilization benchmarks — are noted as unavailable where applicable. The content is intended for coding professionals, orthopedic clinicians, and policy analysts who need a clear summary of CPT code 24586 and its role in surgical fracture care.
Billing Code Overview
CPT code 24586 describes an open surgical repair of an elbow fracture or dislocation involving the distal humerus and proximal radius and/or ulna, performed through one or more incisions over the elbow. The procedure addresses fractures and/or displacement of the elbow joint structures, including the humerus and one or both forearm bones (radius and ulna).
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Service type: Open orthopedic fracture repair of the elbow (operative fracture repair)
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Typical site of service: Hospital operating room or ambulatory surgery center where orthopedic surgical procedures are performed
Clinical & Coding Specifications
Clinical Context
A 42-year-old male presents to the emergency department after a fall onto an outstretched hand with acute pain, swelling, and deformity of the elbow. Imaging (AP and lateral radiographs, with CT if needed) demonstrates a displaced intra-articular distal humerus and proximal radius/ulna fracture-dislocation requiring open reduction and internal fixation. The orthopedic trauma team evaluates the patient, obtains informed consent, schedules the patient for the operating room, and performs the procedure under general anesthesia. One or more surgical incisions are made over the elbow to visualize the articular surfaces; fracture fragments are reduced and stabilized with plates, screws, or other implants. Postoperative care includes immobilization in a splint or hinged elbow brace, pain control, neurovascular checks, and early supervised range-of-motion therapy when stable. Typical site of service is an inpatient or ambulatory surgery center setting depending on fracture complexity and patient medical status. Service type is operative orthopedic fracture repair of the elbow/humerus and/or the proximal radius/ulna as described by 24586.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
51 | Multiple procedures | When 24586 is reported with other distinct surgical procedures during the same operative session. |