# elbow arthroplasty



## betsycpcp (Sep 20, 2011)

*elbow arthroplasty-surgeon vs hospital coding*

The surgeon's bill and the hospital bill have different codes for these procedures and I can't figure out which ones are correct:
1. Right elbow ulnohumeral arthroplasty with contracture release.
2. Hardware removal of right humerus, removal of deep implant from bone.
3. Excision of olecranon osteophyte.

Pre and post op dx: right elbow contracture, status post right humerus fracture and symptomatic hardware.

...We then used a previous posterior incision and used the posterior approach to the distal humerus.  We dissected down to the olecranon tip and then dissected proximally bluntly on the posterior aspect of the humerus.  We identified the posterolateral plate and removed the 2 distal screws there. We then used a carbide tip bur and cut the plate removing the 2 distal screw holes.

Once the plate was removed, we turned our attention to the olecranon fossa and the olecranon tip.  We used an osteotome to remove the olecranon tip osteophyte. Once the osteophytes were removed, and we had access to the distal humerus olecranon fossa, we then used a circular drill and performed our ulnohumeral arthroplasty.  Once this was done, we then sent the olecranon osteophytes, as well as the bone resected from the ulnohumeral arthroplasty to pathology...

The surgeon billed 
24149-RT
24120-59
20680-59
The hospital billed
24147-RT
20680
20999

We are the payer (workers' comp)- in order to get the unlisted code paid we have to verify and document that it's correct, but I'm finding unclear and conflicting information on how to code these procedures--any help would be appreciated.  Thanks!


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