Hello, I have a surgery that the Dr. has coded with 24149 - Radical resection of capsule, soft tissue, and heterotopic bone, elbow, with contracture release (separate procedure).

The catch is, he did the surgery arthroscopically. I was thinking of billing as 29999 with 24149 as the comp code. Wanted to get other opinions as I didn't know if there is a better code that I am missing. Thanks. OP note details are below.

PROCEDURE IN DETAIL: After induction of anesthesia and administration of IV antibiotics, surgical pause was conducted. The patient was examined with a stated range of motion above. He was then rolled into the lateral decubitus position with all bony prominences well padded. The right arm was prepped, draped, and placed on however a feet roller. The arm was elevated, exsanguinated, and tourniquet was inflated to 250 mmHg pressure. A posterior row lateral and midline posterior arthroscopy portal were established. The entire olecranon fossa was filled with muscle and scar tissue. This was resected using ArthroCare wand and shaver. As the ulnar nerve could be palpated anterior to the medial epicondyle, I used the ArthroCare to release the posterior band of the medial collateral ligament and released the posteromedial gutter similarly. I released the posterolateral gutter by looking from the midline portal and working from the lateral portal. There was some ectopic bone in the olecranon fossa, which I resected with the shaver using bone cutting shaver on high-speed forward. Next, I entered the anterior aspect of the elbow, this was completely obliterated, and I had a difficult time finding bony landmarks without staying on the humerus and resecting all of the inflamed scarred muscle and other tissue, which were adherent to the joint. Once, I had completely released all the soft tissue, I could safely release and then perform gentle manipulation, obtaining full extension of the elbow with hyperextension and flexion up to 135 to 40 degrees. The portals were then closed with 3-0 nylon. A soft dressing was applied. The patient was returned to the recovery room without incident.