How To Use CPT Code 25000

CPT code 25000 describes the procedure of making an incision into the wrist’s extensor tendon sheath to release the contracture of the tendon. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 25000?

CPT 25000 is a code used to describe the procedure of making an incision into the wrist’s extensor tendon sheath to release the contracture of the tendon. This procedure is typically performed to alleviate the symptoms of de Quervain’s disease, a painful inflammation of the thumb tendons that extend to the wrist.

2. Official Description

The official description of CPT code 25000 is: ‘Incision, extensor tendon sheath, wrist (eg, de Quervain’s disease).’ This code is used when the provider makes an incision into the wrist’s extensor tendon sheath to release the contracture of the tendon.

3. Procedure

During the procedure described by CPT 25000, the provider makes an incision over the dorsal (upper) side of the wrist near the thumb. The incision is brought down to the level of the tendon sheath. After exposing the sheath, the provider makes an incision to loosen it and releases the contracture that has been causing pressure on the extensor tendon. Once the release is confirmed, the provider irrigates the area and closes the wound with sutures.

4. Qualifying circumstances

CPT 25000 is typically performed on patients with de Quervain’s disease, a condition characterized by inflammation of the thumb tendons that extend to the wrist. The procedure is indicated when the patient experiences symptoms such as pain, swelling, and difficulty moving the thumb and wrist. The provider must assess the patient’s condition and determine the need for the release of the extensor tendon sheath.

5. When to use CPT code 25000

CPT code 25000 should be used when the provider performs the specific procedure of making an incision into the wrist’s extensor tendon sheath to release the contracture of the tendon. It is important to ensure that the procedure is performed for the treatment of de Quervain’s disease and not for other conditions or purposes.

6. Documentation requirements

To support a claim for CPT 25000, the provider must document the following information:

• Patient’s diagnosis of de Quervain’s disease
• Confirmation of the need for the release of the extensor tendon sheath
• Date of the procedure
• Details of the procedure, including the incision made and the release of the contracture
• Confirmation of complete release
• Wound irrigation and closure

7. Billing guidelines

When billing for CPT 25000, ensure that the procedure is performed as described in the official description. It is important to accurately document the diagnosis and procedure details to support the claim. CPT code 25000 should not be reported with other codes unless there are specific circumstances that warrant additional codes.

8. Historical information

CPT code 25000 was added to the Current Procedural Terminology system on January 1, 1990. The code description was updated on January 1, 2018, to include the specific mention of de Quervain’s disease.

9. Similar codes to CPT 25000

There are several similar codes to CPT 25000 that describe procedures on the forearm and wrist. These include:

• CPT 25001: Incision, extensor tendon sheath, wrist (eg, de Quervain’s disease); with release of tendon
• CPT 25020: Incision, extensor tendon sheath, forearm and/or wrist (eg, tenosynovitis)
• CPT 25023: Incision, extensor tendon sheath, forearm and/or wrist (eg, tenosynovitis); with release of tendon
• CPT 25028: Incision, extensor tendon sheath, forearm and/or wrist (eg, tenosynovitis); with tenolysis
• CPT 25031: Incision, extensor tendon sheath, forearm and/or wrist (eg, tenosynovitis); with tenolysis and repair

9. Examples

1. A patient with de Quervain’s disease undergoes an incision into the wrist’s extensor tendon sheath to release the contracture of the tendon.
2. A provider performs the procedure on a patient experiencing pain and swelling in the wrist and thumb due to tenosynovitis.
3. A patient with a confirmed diagnosis of de Quervain’s disease undergoes the procedure to alleviate symptoms and improve thumb and wrist mobility.
4. A provider performs the procedure on a patient with a history of repetitive hand movements and symptoms consistent with extensor tendon contracture.
5. A patient with persistent pain and limited range of motion in the wrist and thumb undergoes the procedure to address the underlying cause.
6. A provider performs the procedure on a patient who has failed conservative treatments for de Quervain’s disease.
7. A patient with a confirmed diagnosis of tenosynovitis undergoes the procedure to release the contracture and improve hand function.
8. A provider performs the procedure on a patient with a traumatic injury to the wrist and thumb, resulting in extensor tendon contracture.
9. A patient with chronic inflammation of the extensor tendon sheath undergoes the procedure to alleviate pain and improve hand function.
10. A provider performs the procedure on a patient with a history of repetitive strain injury and symptoms consistent with extensor tendon contracture.