2025 CPT code 23935
(Active) Effective Date: N/A Revision Date: N/A Surgery - Incision Procedures on the Humerus (Upper Arm) and Elbow Surgical Procedures on the Musculoskeletal System Feed
Deep incision with opening of the bone cortex (e.g., for osteomyelitis or bone abscess) in the humerus or elbow.
Modifiers may be used to indicate additional services or circumstances, such as 51 (multiple procedures), 76 (repeat procedure), or 59 (distinct procedural service), as per CPT guidelines.
Medical necessity for code 23935 is established by the presence of a bone abscess or osteomyelitis in the humerus or elbow area that requires surgical intervention for adequate drainage, debridement, and treatment of the infection.Evidence supporting the diagnosis and the need for surgical intervention must be present in the medical record.
The physician or qualified healthcare professional performs the incision, bone access, drainage, debridement, irrigation, and wound closure. Postoperative care and splint application might be included or billed separately.
- Surgical Procedures on the Musculoskeletal System
- Surgical Procedures on the Musculoskeletal System > Surgical Procedures on the Humerus (Upper Arm) and Elbow > Incision Procedures on the Humerus (Upper Arm) and Elbow
In simple words: The doctor makes a deep cut to open the bone in the upper arm or elbow to treat a serious infection or abscess.Pus is drained, infected bone is removed, and the area is cleaned. The cut is then closed (possibly later), and a splint may be used to help healing.
This procedure involves a deep incision to access and open the bone cortex of the humerus or elbow, typically to address conditions such as osteomyelitis or a bone abscess.The incision allows for drainage of the abscess, removal of infected bone tissue (debridement), and irrigation of the affected area.The periosteum may be incised, the medullary cavity opened (via drill holes or a bone window), and the wound subsequently closed (primary or delayed closure) with possible splinting for post-operative support.
Example 1: A patient presents with acute osteomyelitis of the humerus.Code 23935 is used to document the surgical procedure to debride the infected bone and drain the abscess., A patient with a chronic bone abscess in the elbow undergoes surgical drainage and debridement.Code 23935 is appropriate for this procedure., A patient sustains a humeral fracture with subsequent infection and abscess formation.Surgical intervention includes fracture management and use of code 23935 to address the infected bone.
Preoperative and postoperative diagnoses, operative report detailing the incision, debridement, drainage, irrigation, and wound closure techniques, imaging studies (X-ray, MRI) demonstrating the abscess or osteomyelitis, and pathology reports if applicable are necessary.
** Consider using additional codes to describe any associated procedures like fracture repair, or other complications.Always refer to the most up-to-date CPT manual for accurate coding.
- Payment Status: Active
- Specialties:Orthopedic surgery, trauma surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center, Outpatient Hospital