Summary & Overview
CPT 24635: Open Repair of Ulna Fracture at Elbow with Radial Head Displacement
CPT code 24635 designates open repair of an ulna fracture at the elbow with displacement of the radial head, typically performed with realignment of the joint and internal fixation using wires or plates. This operative code captures a common upper-extremity trauma procedure that has implications for surgical billing, device use, and postoperative rehabilitation. Nationally, accurate coding for these procedures affects hospital and ambulatory surgical center revenue cycles and supports appropriate tracking of trauma surgical volumes.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication summarizes coverage patterns, common payment considerations, and coding contexts across major commercial insurers and the federal program.
Readers will find a concise clinical context for the procedure, typical sites of service, and the operational elements relevant to billing and claims submission. The report provides benchmark perspectives, notes on reimbursement policy updates where available, and guidance on documentation elements that typically support this surgical code. Data not available in the input is noted where payer-specific rates, associated taxonomies, and ICD-10 mappings are absent.
Billing Code Overview
CPT code 24635 describes surgical repair of a fractured ulna at the elbow with displacement of the radial head. The procedure involves realignment of the ulna and radial head and may include internal fixation such as wires or plates to stabilize the forearm bones during healing.
-
Service type: Open reduction and internal fixation of ulna fracture with manipulation/realignment of the elbow joint
-
Typical site of service: Hospital operating room or ambulatory surgical center, with postoperative care in inpatient or outpatient surgical follow-up settings
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 34-year-old male presents to the emergency department after a fall from a bicycle onto an outstretched hand. He has acute left elbow pain, visible deformity, swelling, and limited forearm rotation. Radiographs and CT confirm a displaced fracture of the proximal ulna with dislocation or displacement of the radial head (Monteggia variant). The patient is admitted to the orthopaedic service. Preoperative evaluation includes neurovascular exam, radiographic templating, informed consent, and optimization for anesthesia. In the operating room under general or regional anesthesia, the orthopaedic surgeon performs open reduction and internal fixation of the ulna fracture with realignment of the proximal radioulnar joint; fixation may include plates, screws, and/or Kirschner wires. Intraoperative fluoroscopy confirms reduction. Postoperative care includes pain control, immobilization or splinting, neurovascular checks, discharge planning with instructions for elevation and wound care, and planned outpatient follow-up for suture removal and initiation of rehabilitation to restore elbow and forearm function.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT / RT | Left or right side designators | Use to indicate laterality of the procedure when required by the payer or facility billing. |