Mastering the Changes - From Code Updates to Compliance: Session 1 - Elbow/Forearm-Mastering the Changes

Mastering the Changes - Session 1 Handout

Pdf Summary

This presentation, part of the AAOE Coding Series February 2026 by Margie Scalley Vaught, focuses on coding for orthopedic procedures involving the elbows and forearms. It highlights essential anatomy, typical procedures, coding challenges, and strategies for accurate coding, prior authorization, and appeals.<br /><br />Key anatomical components covered include the elbow joints (radiohumeral, ulnohumeral, superior radioulnar), ligaments like the ulnar (medial) and radial (lateral) collateral, annular ligament, muscles such as biceps, brachialis, and forearm extensors, as well as nerves (ulnar, median, radial) and arteries (brachial artery).<br /><br />Orthopedic emergencies such as compartment syndrome are addressed with specific CPT codes for pressure monitoring (20950) and various fasciotomy procedures depending on location and extent (codes 24495, 25020 series). ICD-10 codes differentiate traumatic and nontraumatic compartment syndromes.<br /><br />Detailed coding guidance is provided for surgeries including excision of olecranon bursa (24105), muscle and tendon repairs (24341, 24342), lateral and medial collateral ligament repair/reconstruction (24343–24346), tennis elbow procedures (24357–24359), and total elbow arthroplasty with corresponding inclusions and exclusions.<br /><br />Coding distinctions are clarified for prosthesis removal versus foreign body removal, and for complex procedures such as the Outerbridge-Kashiwagi ulnohumeral arthroplasty (coded as 24006 or unlisted code 24999), radial head arthroplasty (24366), elbow capsular release with hardware removal, and neuroplasty including ulnar nerve transposition (64718).<br /><br />Special considerations include the non-usage of tenotomy codes for ultrasonic debridement (Tenex procedure coded as unlisted 24999) and the challenges in fracture coding requiring careful anatomic specificity, with recommended CPT codes for distal humerus, epicondylar, condylar, periarticular fractures, and proximal ulna fractures, outlining included/excluded procedures.<br /><br />The presentation reinforces the importance of precise documentation for proper code selection, ensuring compliance with current CPT guidelines, and facilitating accurate reimbursement and appeals. It serves as a comprehensive coding resource for clinicians and coders managing elbow and forearm orthopedic cases.

Keywords

Orthopedic coding

Elbow procedures

Forearm surgeries

Compartment syndrome coding

CPT codes

ICD-10 codes

Ligament repair

Tennis elbow treatment

Elbow arthroplasty

Ulnohumeral arthroplasty