A patient is seen in the hospital’s outpatient surgical area with a diagnosis of a displaced fracture of the lateral condyle, right elbow. An ORIF (open reduction) procedure was performed and included the following techniques: An incision was made in the area of the lateral epicondyle. This was carried through subcutaneous tissue, and the fracture site was easily exposed. Inspection revealed the fragment to be rotated in two places about 90 degrees. It was possible to manually reduce this quite easily, and the manipulation resulted in an almost anatomic reduction. This was fixed with two pins driven across the humerus. The pins were cut off below skin level. The wound was closed with plain catgut subcutaneously and 5-0 nylon for the skin. Dressings and a long arm cast were applied. What CPT® and ICD-10-CM codes are reported? a. 24579-RT, 29065-51-RT, S42.434B b. 24575-RT, S42.434B c. 24579-RT, S42.451A d. 24577-RT, S42.451A

A patient presented with a closed, displaced supracondylar fracture of the left elbow. After conscious sedation, the left upper extremity was draped and closed reduction was performed, achieving anatomical reduction of the fracture. The elbow was then prepped and with the use of fluoroscopic guidance, two K-wires were directed crossing the fracture site and piercing the medial cortex of the left distal humerus. Stable reduction was obtained, with full flexion and extension. K-wires were bent and cut at a 90-degree angle. Telfa padding and splint were applied. What CPT® code(s) is/are reported? a. 24538-LT b. 24535-LT, 29105-LT c. 24566-LT, 29105-LT d. 24582-LT

A 66-year-old sustained a left proximal humerus fracture. Standard deltopectoral approach was used and dissection was carried down to the fracture site. The fracture site was identified and fragments were mobilized and the humeral head fragments removed. Once this was done, the stem was prepared up to a size 10. A trial reduction was carried out with the DePuy trial stem and implant head. Sutures were placed in key positions for closure of the tuberosities down to the shaft including sutures through the shaft. The shaft was then prepared and cement was injected into the shaft. The implant was placed. Once the cement was hardened, the head was placed on Morse taper and reduced. A bone graft was placed around the area where the tuberosities were being brought down. The tuberosities were then tied down with a suture previously positioned. This gave excellent closure and coverage of the significant motion at the repair sites. The wound was thoroughly irrigated. The skin was closed with Vicryl over a drain and also staples in the epidermis. A sterile dressing and sling was applied. The patient was taken to recovery in stable condition. No immediate complications. What CPT® code is reported? a. 23605-LT b. 23616-LT c. 23670-LT d. 23615-LT

The patient is a 17-year-old male who was struck on the elbow by another player’s stick while playing hockey. He is found to have a fracture of the olecranon process. The patient was brought to the OR, anesthetized and intubated. The right upper extremity was prepped with Betadine scrub and draped free in the usual sterile orthopedic manner. The arm was then elevated and exsanguinated and the tourniquet inflated to 250 mm/Hg. A five-inch incision was made with the scalpel on the extensor side of the elbow, beginning distally and proceeding in an oblique fashion up the proximal forearm. Dissection was carried through subcutaneous tissue and fascia, and bleeding was controlled with electrocautery. We then subperiosteally exposed the proximal ulna and olecranon to visualize the fracture site. The fracture could be seen at the base of the olecranon process. We irrigated the site thoroughly and reduced the fracture fragments without difficulty. Extending the elbow, we inserted two smooth K-wires across the fracture site. Through a drill hole in the proximal ulnar shaft, we threaded an 18-gauge wire through it and wrapped it around the K-wires in a figure-of-eight manner to further stabilize the fixation. Wires were then twisted and placed into soft tissues. The K-wires in the olecranon were advanced slightly after being bent and cut. Sterile dressing was applied and the patient was placed in a splint. What CPT® code is reported? a. 24635-RT b. 24685-RT c. 24586-RT d. 24675-RT

Which one of the following nerves is at risk of injury following fracture of shaft of humerus?

A 6-year-old male suffered a fracture after falling off the monkey bars at school. He fell on an outstretched hand and suffered a transcondylar fracture of the left humerus. After prep and drape, a manipulation was done to achieve anatomic reduction. Once the joint was adequately reduced, pins were placed through the skin distally and proximally into the bone to maintain excellent fixation and anatomic reduction. The pins were bent, trimmed and covered with a sterile dressing and a posterior splint was placed on the patient’s arm. What CPT® code is reported? a. 24546-LT b. 24530-LT c. 24538-LT d. 24516-LT