Summary & Overview
CPT 24685: Open Treatment of Proximal Ulna Fracture with Internal Fixation
CPT code 24685 denotes open treatment of a proximal ulna fracture via an incision at the elbow, often including internal fixation with screws or wires. This surgical code captures definitive operative management of elbow-end ulnar fractures and is a key procedural entry for surgical orthopedics and trauma care billing. Nationally, accurate use of this code affects hospital and ambulatory surgery center case-mix reporting, surgical quality measurement, and payment adjudication for upper-extremity trauma.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise account of clinical context for the procedure, typical sites of service, and commonly associated billing considerations. The publication provides benchmarks for utilization and payment patterns where available, notes common modifier use supplied in the input, and summarizes implications for documentation and coding consistency in orthopedic trauma settings.
The content is organized to help coding professionals, practice managers, and policymakers understand the clinical scenario captured by CPT code 24685, how it maps to surgical workflows, and what elements of documentation and claim submission typically accompany such an operative fracture repair.
Billing Code Overview
CPT code 24685 describes an open treatment of a proximal ulna fracture through an incision at the elbow. The procedure can include internal fixation methods such as screws or wires to stabilize the fracture.
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Service type: Open surgical fracture treatment with internal fixation
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Typical site of service: Operating room or surgical suite in an inpatient or outpatient hospital setting, or an ambulatory surgery center
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 42-year-old male presents to the emergency department after a fall onto an outstretched hand with immediate pain, swelling, and deformity about the proximal forearm/elbow. Radiographs demonstrate a displaced proximal ulna fracture involving the olecranon or proximal shaft. After closed reduction attempts are inadequate to restore alignment and stability, the patient is scheduled for operative fixation. In the operating room under general or regional anesthesia, the surgeon makes a posterior or curvilinear incision at the elbow, exposes the proximal ulna fracture, reduces the fragments anatomically, and secures fixation using plates and screws, tension band wiring, or intramedullary fixation as indicated. Perioperative workflow includes preoperative imaging review, informed consent, anesthesia evaluation, intraoperative fluoroscopy to confirm reduction, sterile operative fixation, application of dressing and splint, postoperative pain control and instructions, and ordering of follow-up radiographs and clinic visits for wound check and hardware assessment.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the surgeon's professional portion distinct from technical services performed by facility or another entity. |
50 |