Orthopedic Coding Alert

Question: Our physician documented open treatment of a radial head fracture with radial head excision, along with an arthroplasty of the radial head with implant. He wrote -24366 and 24666- on the chart. Can I report both codes for this service?

Arizona Subscriber Answer: You should report 24666 (Open treatment of radial head or neck fracture, with or without internal fixation or radial head excision; with radial head prosthetic replacement), because this code includes the fracture treatment, the excision, and the radial head prosthetic replacement.

Code 24366 (Arthroplasty, radial head; with implant) applies when your surgeon uses a prosthesis for more chronic conditions, when a fracture is not present. But you cannot report both 24666 and 24366 together, because the codes describe the same operation, but for different indications. Therefore, determine which of these codes best fits your surgeon's documentation and report just that code.