# Topaz Procedure



## Kae Hunter CPC (Feb 2, 2009)

Our Physician Has Done A Topaz Procedure For Lateral Epicondylitis.  He Says To Bill 24310 Because That Is What The Rep Told Him To Use.  As I Read The Cpt Book Code 24357 Seems To Be The Correct Code.  Can Anyone Help Me With This?


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## RebeccaWoodward* (Feb 2, 2009)

I agree with you...24357


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## mbort (Feb 2, 2009)

Kae Hunter CPC said:


> Our Physician Has Done A Topaz Procedure For Lateral Epicondylitis.  He Says To Bill 24310 Because That Is What The Rep Told Him To Use.  As I Read The Cpt Book Code 24357 Seems To Be The Correct Code.  Can Anyone Help Me With This?



typically from what I have seen in the past, with the Topaz, no incisions are made (however not unheard of).  Usually for other body parts its an unlisted code so I would be curious to see an op note on this case.

Can you post the op note?

thanks
Mary, CPC, COSC


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## Kae Hunter CPC (Feb 2, 2009)

I Am Unable To Send The Op Note; But It Says "after Sterile Prepping And Draping Incision Was Made Over The Lateral Epicondyle.
Thanks, Kae


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## mbort (Feb 2, 2009)

Kae Hunter CPC said:


> I Am Unable To Send The Op Note; But It Says "after Sterile Prepping And Draping Incision Was Made Over The Lateral Epicondyle.
> Thanks, Kae




I'm not convinced that 24357 is correct.


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## RebeccaWoodward* (Feb 2, 2009)

Lateral epicondylar release

Q. Some of us have started doing a modified lateral epicondylar release using a Topaz thermal cautery device. Would we be able to report 25290—Tenotomy, open, flexor or extensor tendon, forearm and/or wrist, single, each tendon; 24310—Tenotomy, open, elbow to shoulder, each tendon; and 24356—Fasciotomy, lateral or medial (e.g., tennis elbow or epicondylitis), with partial ostectomy? 

A. This is an extensor origin detachment for lateral epicondylitis, 24351(*now deleted*). The method of tissue dissection or cutting is not relevant. It is the physician’s work—not the tool—that is being reimbursed.

http://www2.aaos.org/aaos/archives/bulletin/apr06/coding2.asp


CPT now directs us to use 24357-24359

Mary is definetly a guru is this area but I do recall this question being asked in one of Ortho seminars that I attended.  Can you type the entire procedure or is it too lengthy?


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## mbort (Feb 2, 2009)

rebeccawoodward said:


> Lateral epicondylar release
> 
> Q. Some of us have started doing a modified lateral epicondylar release using a Topaz thermal cautery device. Would we be able to report 25290—Tenotomy, open, flexor or extensor tendon, forearm and/or wrist, single, each tendon; 24310—Tenotomy, open, elbow to shoulder, each tendon; and 24356—Fasciotomy, lateral or medial (e.g., tennis elbow or epicondylitis), with partial ostectomy?
> 
> ...



I agree that its definitely a possiblity that its correct, but there just isn't enough posted to convince me to commit
thanks Rebecca


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## Kae Hunter CPC (Feb 2, 2009)

Thanks Much To All Who Offered Opinions.  I Have Also Reviewed This With My Mananger And The Final Thought Is That Cpt Codes 24357 Thru 24359 Are The Correct Ones To Use.

Thanks Again,
Kae


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