elbow query

[Jamie Dezenzo]

Hello all,
Elbow synovectomy, capsular excision, heterotopic bone ossificiation removal and aggressive contracture release.

Dx: elbow jt contracture, stiffness with heterotopic ossification

24102 and 24149
per bundling 24102 is the greater procedure?

Thanks!
Jamie

[kumar_sanjeev02]

HI, JAMIE

could you please provide the documentation because i think 24006 is for athrotomy with capsular release which is bundle in 24102. so we can report only 24102 with partial excision code. 24149 is for radical so we need to see how is documentation to support radical code.

Regards
sanjeev

[Jamie Dezenzo]

Sure,
Op reads
" The radiocapitellar jt was addressed. An aggressive synovectomy was performed. I excised as much capsule as possible. There was extensive capsular adhesions anteriorly, which were taken down with combination of sharp and blunt dissection, as well as Key elevator for th a subperiosteal elevation of the capsule off the anterior distal humerus. Heterotopic bone and osteophytes that were present were resected. There was some excess bone formation within the coronoid fossa. Some articulare cartilage loss which was debrided. Ulnar nerve was decompressed.

Then ulnohumeral joint because of the severe extension contracture that present. Excess bone from the posterior aspect of the olecranon fossa. Debrided some mild osteophyte formation on the trochlea and again completed the excision of the tip of the coronoid just proximal to the capsular insertion. Again, synovectomy and capsular excision was performed through the ulnar aspect. There was some significant heterotopic ossification through the anterior bundle of the ulnar collateral ligament, as well as the flexor pronator mass. Then ulnar collateral ligament was repaired with anchor. "

[Jamie Dezenzo]

Any takers???? Thanks for any help!