Orthopedic Coding Alert

Question: How should I code cubital tunnel release? If I use an unlisted procedure code, what procedure should I compare the release to for relative value units (RVUs)?

New Mexico Subscriber

Answer: Your surgeon probably used an open approach, which you should code with CPT 64718 (Neuroplasty and/or transposition; ulnar nerve at elbow). On the rare occasion he performs the procedure endoscopically, report 29999 (Unlisted procedure, arthroscopy) and compare it to 64718 when adjusting for reimbursement.

Caution: Coders are accustomed to seeing carpal tunnel procedures on their desks, not cubital tunnel. Don't submit 29848 (Endoscopy, wrist, surgical, with release of transverse carpal ligament) by mistake, because that represents carpal tunnel surgery.