DecisionHealth, DecisionHealth - 2025 Issue 12 (December)

Q&A: See arthrotomy code for osteophyte removal from bicipital tuberosity

Question: What is more appropriate to bill for removal of osteophyte formations over the bicipital tuberosity and ulna within elbow capsule area? The procedure was described as, “Left elbow open resection of the proximal radius bicipital tuberosity and osteophytes.” Pain due to arthritis is the patient's condition. Original procedure of resection of biceps tendon neglected due to the discovery of these osteophytes. The provider chose CPT 25355 (Osteotomy, radius; middle or proximal third). We don't agree with that because it is an osteophyte/abnormal overgrowth being removed, not the actual bone itself being removed for stability purposes. Instead, our coding team is debating whether it’s CPT code 24149 (Radical resection of capsule, soft tissue, and heterotopic bone, elbow, with contracture release [separate procedure]) or 24155 (Resection of elbow joint [arthrectomy]). Or would it be the unlisted code, 24999?

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