This info listed to assist Dr. W. with coding procedures.
Forearm and Wrist (25000-25999)
Radius, ulna, carpal bones and joints.
Incision (25000-25040)
25000 Incision, extensor tendon sheath, wrist (eg, deQuervains disease)
(For decompression median nerve or for carpal tunnel syndrome, see 64721)
25001 Incision, flexor tendon sheath, wrist (eg, flexor carpi radialis)
25020 Decompression fasciotomy, forearm and/or wrist, flexor OR extensor compartment; without debridement of nonviable muscle and/or nerve
25023 Decompression fasciotomy, forearm and/or wrist, flexor OR extensor compartment; with debridement of nonviable muscle and/or nerve
(For decompression fasciotomy with brachial artery exploration, see 24495)
(For incision and drainage procedures, superficial see 10060 10061 10080 10081 10120 10121 10140 -10160)
(For debridement, see also 11000 11001 11010 11011 11012 11040 11041 11042 11043 -11044)
25024 Decompression fasciotomy, forearm and/or wrist, flexor AND extensor compartment; without debridement of nonviable muscle and/or nerve
25025 Decompression fasciotomy, forearm and/or wrist, flexor AND extensor compartment; with debridement of nonviable muscle and/or nerve
25028 Incision and drainage, forearm and/or wrist; deep abscess or hematoma
25031 Incision and drainage, forearm and/or wrist; bursa
25035 Incision, deep, bone cortex, forearm and/or wrist (eg, osteomyelitis or bone abscess)
25040 Arthrotomy, radiocarpal or midcarpal joint, with exploration, drainage, or removal of foreign body
Excision (25065-25240)
25065 Biopsy, soft tissue of forearm and/or wrist; superficial
25066 Biopsy, soft tissue of forearm and/or wrist; deep (subfascial or intramuscular)
(For needle biopsy of soft tissue, use 20206)
25075 Excision, tumor, soft tissue of forearm and/or wrist area; subcutaneous
25076 Excision, tumor, soft tissue of forearm and/or wrist area; deep (subfascial or intramuscular)
25077 Radical resection of tumor (eg, malignant neoplasm), soft tissue of forearm and/or wrist area
25085 Capsulotomy, wrist (eg, contracture)
25100 Arthrotomy, wrist joint; with biopsy
25101 Arthrotomy, wrist joint; with joint exploration, with or without biopsy, with or without removal of loose or foreign body
25105 Arthrotomy, wrist joint; with synovectomy
25107 Arthrotomy, distal radioulnar joint including repair of triangular cartilage, complex
25110 Excision, lesion of tendon sheath, forearm and/or wrist
25111 Excision of ganglion, wrist (dorsal or volar); primary
25112 Excision of ganglion, wrist (dorsal or volar); recurrent
(For hand or finger, see 26160)
25115 Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, Tbc, or other granulomas, rheumatoid arthritis); flexors
25116 Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, Tbc, or other granulomas, rheumatoid arthritis); extensors, with or without transposition of dorsal retinaculum
(For finger synovectomies, see 26145)
25118 Synovectomy, extensor tendon sheath, wrist, single compartment;
25119 Synovectomy, extensor tendon sheath, wrist, single compartment; with resection of distal ulna
25120 Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process);
(For head or neck of radius or olecranon process, see 24120 24125 -24126)
25125 Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process); with autograft (includes obtaining graft)
25126 Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process); with allograft
25130 Excision or curettage of bone cyst or benign tumor of carpal bones;
25135 Excision or curettage of bone cyst or benign tumor of carpal bones; with autograft (includes obtaining graft)
25136 Excision or curettage of bone cyst or benign tumor of carpal bones; with allograft
25145 Sequestrectomy (eg, for osteomyelitis or bone abscess), forearm and/or wrist
25150 Partial excision (craterization, saucerization or diaphysectomy) of bone (eg, for osteomyelitis); ulna
25151 Partial excision (craterization, saucerization or diaphysectomy) of bone (eg, for osteomyelitis); radius
(For head or neck of radius or olecranon process, see 24145, 24147)
25170 Radical resection for tumor, radius or ulna
25210 Carpectomy; one bone
(For carpectomy with implant, see 25441 25442 25443 25444 -25445)
25215 Carpectomy; all bones of proximal row
25230 Radial styloidectomy (separate procedure)
25240 Excision distal ulna partial or complete (eg, Darrach type or matched resection)
(For implant replacement, distal ulna, see 25442)
(For obtaining fascia for interposition, see 20920, 20922)
Introduction or Removal (25246-25259)
(For K-wire, pin or rod insertion or removal, see 20650, 20670, 20680)
25246 Injection procedure for wrist arthrography
(For radiological supervision and interpretation, see 73115. Do not report 76003 in addition to 73115)
(For foreign body removal, superficial see 20520)
25248 Exploration with removal of deep foreign body, forearm or wrist
25250 Removal of wrist prosthesis; (separate procedure)
25251 Removal of wrist prosthesis; complicated, including total wrist
25259 Manipulation, wrist, under anesthesia
(For application of external fixation, see 20690 or 20692)
Repair, Revision, and/or Reconstruction (25260-25492)
25260 Repair, tendon or muscle, flexor, forearm and/or wrist; primary, single, each tendon or muscle
25263 Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, single, each tendon or muscle
25265 Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, with free graft (includes obtaining graft), each tendon or muscle
25270 Repair, tendon or muscle, extensor, forearm and/or wrist; primary, single, each tendon or muscle
25272 Repair, tendon or muscle, extensor, forearm and/or wrist; secondary, single, each tendon or muscle
25274 Repair, tendon or muscle, extensor, forearm and/or wrist; secondary, with free graft (includes obtaining graft), each tendon or muscle
25275 Repair, tendon sheath, extensor, forearm and/or wrist, with free graft (includes obtaining graft) (eg, for extensor carpi ulnaris subluxation)
25280 Lengthening or shortening of flexor or extensor tendon, forearm and/or wrist, single, each tendon
25290 Tenotomy, open, flexor or extensor tendon, forearm and/or wrist, single, each tendon
25295 Tenolysis, flexor or extensor tendon, forearm and/or wrist, single, each tendon
25300 Tenodesis at wrist; flexors of fingers
25301 Tenodesis at wrist; extensors of fingers
25310 Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; each tendon
25312 Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; with tendon graft(s) (includes obtaining graft), each tendon
25315 Flexor origin slide (eg, for cerebral palsy, Volkmann contracture), forearm and/or wrist;
25316 Flexor origin slide (eg, for cerebral palsy, Volkmann contracture), forearm and/or wrist; with tendon(s) transfer
25320 Capsulorrhaphy or reconstruction, wrist, open (eg, capsulodesis, ligament repair, tendon transfer or graft) (includes synovectomy, capsulotomy and open reduction) for carpal instability
25332 Arthroplasty, wrist, with or without interposition, with or without external or internal fixation
(For obtaining fascia for interposition, see 20920, 20922)
(For prosthetic replacement arthroplasty, see 25441 25442 25443 25444 25445 -25446)
25335 Centralization of wrist on ulna (eg, radial club hand)
25337 Reconstruction for stabilization of unstable distal ulna or distal radioulnar joint, secondary by soft tissue stabilization (eg, tendon transfer, tendon graft or weave, or tenodesis) with or without open reduction of distal radioulnar joint
(For harvesting of fascia lata graft, see 20920, 20922)
25350 Osteotomy, radius; distal third
25355 Osteotomy, radius; middle or proximal third
25360 Osteotomy; ulna
25365 Osteotomy; radius AND ulna
25370 Multiple osteotomies, with realignment on intramedullary rod (Sofield type procedure); radius OR ulna
25375 Multiple osteotomies, with realignment on intramedullary rod (Sofield type procedure); radius AND ulna
25390 Osteoplasty, radius OR ulna; shortening
25391 Osteoplasty, radius OR ulna; lengthening with autograft
25392 Osteoplasty, radius AND ulna; shortening (excluding 64876)
25393 Osteoplasty, radius AND ulna; lengthening with autograft
25394 Osteoplasty, carpal bone, shortening
25400 Repair of nonunion or malunion, radius OR ulna; without graft (eg, compression technique)
25405 Repair of nonunion or malunion, radius OR ulna; with autograft (includes obtaining graft)
25415 Repair of nonunion or malunion, radius AND ulna; without graft (eg, compression technique)
25420 Repair of nonunion or malunion, radius AND ulna; with autograft (includes obtaining graft)
25425 Repair of defect with autograft; radius OR ulna
25426 Repair of defect with autograft; radius AND ulna
25430 Insertion of vascular pedicle into carpal bone (eg, Hori procedure)
25431 Repair of nonunion of carpal bone (excluding carpal scaphoid (navicular)) (includes obtaining graft and necessary fixation), each bone
25440 Repair of nonunion, scaphoid carpal (navicular) bone, with or without radial styloidectomy (includes obtaining graft and necessary fixation)
25441 Arthroplasty with prosthetic replacement; distal radius
25442 Arthroplasty with prosthetic replacement; distal ulna
25443 Arthroplasty with prosthetic replacement; scaphoid carpal (navicular)
25444 Arthroplasty with prosthetic replacement; lunate
25445 Arthroplasty with prosthetic replacement; trapezium
25446 Arthroplasty with prosthetic replacement; distal radius and partial or entire carpus (total wrist)
25447 Arthroplasty, interposition, intercarpal or carpometacarpal joints
(For wrist arthroplasty, use 25332)
25449 Revision of arthroplasty, including removal of implant, wrist joint
25450 Epiphyseal arrest by epiphysiodesis or stapling; distal radius OR ulna
25455 Epiphyseal arrest by epiphysiodesis or stapling; distal radius AND ulna
25490 Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; radius
25491 Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; ulna
25492 Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; radius AND ulna
Fracture and/or Dislocation (25500-25695)
25500 Closed treatment of radial shaft fracture; without manipulation
25505 Closed treatment of radial shaft fracture; with manipulation
25515 Open treatment of radial shaft fracture, with or without internal or external fixation
25520 Closed treatment of radial shaft fracture, and closed treatment of dislocation of distal radio-ulnar joint (Galeazzi fracture/dislocation)
25525 Open treatment of radial shaft fracture, with internal and/or external fixation and closed treatment of dislocation of distal radio-ulnar joint (Galeazzi fracture/dislocation), with or without percutaneous skeletal fixation
25526 Open treatment of radial shaft fracture, with internal and/or external fixation and open treatment, with or without internal or external fixation of distal radio-ulnar joint (Galeazzi fracture/dislocation), includes repair of triangular fibrocartilage complex
25530 Closed treatment of ulnar shaft fracture; without manipulation
25535 Closed treatment of ulnar shaft fracture; with manipulation
25545 Open treatment of ulnar shaft fracture, with or without internal or external fixation
25560 Closed treatment of radial and ulnar shaft fractures; without manipulation
25565 Closed treatment of radial and ulnar shaft fractures; with manipulation
25574 Open treatment of radial AND ulnar shaft fractures, with internal or external fixation; of radius OR ulna
25575 Open treatment of radial AND ulnar shaft fractures, with internal or external fixation; of radius AND ulna
25600 Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation, with or without fracture of ulnar styloid; without manipulation
25605 Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation, with or without fracture of ulnar styloid; with manipulation
25606 Percutaneous skeletal fixation of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation, with or without fracture of ulnar styloid, requiring manipulation, with or without external fixation (uniplane ext fix 20690, multiplane 20692, adjustment requiring anesth 20693, removal requiring anesthesia 20694)
25608 Open treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation with internal fixation of 2 fragments
25609 with internal fixation of 3 or more fragments
25622 Closed treatment of carpal scaphoid (navicular) fracture; without manipulation
25624 Closed treatment of carpal scaphoid (navicular) fracture; with manipulation
25628 Open treatment of carpal scaphoid (navicular) fracture, with or without internal or external fixation
25630 Closed treatment of carpal bone fracture (excluding carpal scaphoid (navicular)); without manipulation, each bone
25635 Closed treatment of carpal bone fracture (excluding carpal scaphoid (navicular)); with manipulation, each bone
25645 Open treatment of carpal bone fracture (other than carpal scaphoid (navicular)), each bone
25650 Closed treatment of ulnar styloid fracture
25651 Percutaneous skeletal fixation of ulnar styloid fracture
25652 Open treatment of ulnar styloid fracture
25660 Closed treatment of radiocarpal or intercarpal dislocation, one or more bones, with manipulation
25670 Open treatment of radiocarpal or intercarpal dislocation, one or more bones
25671 Percutaneous skeletal fixation of distal radioulnar dislocation
25675 Closed treatment of distal radioulnar dislocation with manipulation
25676 Open treatment of distal radioulnar dislocation, acute or chronic
25680 Closed treatment of trans-scaphoperilunar type of fracture dislocation, with manipulation
25685 Open treatment of trans-scaphoperilunar type of fracture dislocation
25690 Closed treatment of lunate dislocation, with manipulation
25695 Open treatment of lunate dislocation
Arthrodesis (25800-25830)
25800 Arthrodesis, wrist, complete; without bone graft (includes radiocarpal and/or intercarpal and/or carpometacarpal joints)
25805 Arthrodesis, wrist, complete; with sliding graft
25810 Arthrodesis, wrist, complete; with iliac or other autograft (includes obtaining graft)
25820 Arthrodesis, wrist, limited; without bone graft (eg, intercarpal or radiocarpal)
25825 Arthrodesis, wrist, limited; with autograft (includes obtaining graft)
25830 Arthrodesis, distal radioulnar joint with segmental resection of ulna, with or without bone graft (eg, Sauve-Kapandji procedure)
Amputation (25900-25931)
25900 Amputation, forearm, through radius and ulna;
25905 Amputation, forearm, through radius and ulna; open, circular (guillotine)
25907 Amputation, forearm, through radius and ulna; secondary closure or scar revision
25909 Amputation, forearm, through radius and ulna; re-amputation
25915 Krukenberg procedure
25920 Disarticulation through wrist;
25922 Disarticulation through wrist; secondary closure or scar revision
25924 Disarticulation through wrist; re-amputation
25927 Transmetacarpal amputation;
25929 Transmetacarpal amputation; secondary closure or scar revision
25931 Transmetacarpal amputation; re-amputation
Other Procedures (25999-25999)
25999 Unlisted procedure, forearm or wrist
