How To Use CPT Code 25001

CPT 25001 describes the incision of a flexor tendon sheath in the wrist to relieve pain and improve mobility in inflammatory conditions such as rheumatoid arthritis or carpal tunnel syndrome. 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 25001?

CPT 25001 is used to describe the incision of a flexor tendon sheath in the wrist. This procedure is performed to alleviate pain and enhance mobility in patients with inflammatory conditions like rheumatoid arthritis or carpal tunnel syndrome. By making an incision and accessing the flexor carpi radialis tendon sheath, the healthcare provider can free the tendon from any adhesions and remove the synovial membrane around it.

2. Official Description

The official description of CPT code 25001 is: ‘Incision, flexor tendon sheath, wrist (e.g., flexor carpi radialis).’ This code specifically refers to the incision made in the wrist to access the flexor carpi radialis tendon sheath.

3. Procedure

During the procedure for CPT 25001, the healthcare provider follows these steps:

1. The patient is appropriately prepped and anesthetized.
2. An incision is made in the wrist over the flexor carpi radialis tendon.
3. The incision extends along the radial aspect of the first metacarpal, avoiding crossing the wrist flexion crease at a right angle.
4. The superficial branch of the radial nerve and the palmar branch of the radial artery are identified and protected.
5. The flexor carpi radialis tendon sheath is opened.
6. Any adhesions around the tendon are freed.
7. The synovial membrane surrounding the tendon is excised.
8. The wound is irrigated.
9. The skin is closed in layers.

4. Qualifying circumstances

CPT 25001 is performed on patients with inflammatory conditions affecting the wrist, such as rheumatoid arthritis or carpal tunnel syndrome. The procedure is intended to relieve pain and improve mobility in these patients. It is important to note that the procedure should only be performed by a qualified healthcare provider.

5. When to use CPT code 25001

CPT code 25001 should be used when a healthcare provider performs an incision of the flexor tendon sheath in the wrist to alleviate pain and improve mobility in patients with inflammatory conditions like rheumatoid arthritis or carpal tunnel syndrome. It is important to ensure that the procedure is medically necessary and appropriate for the patient’s condition.

6. Documentation requirements

To support a claim for CPT 25001, the healthcare provider must document the following information:

• Patient’s diagnosis and the medical necessity of the procedure
• Details of the incision, including the location and size
• Steps taken during the procedure, such as freeing adhesions and excising the synovial membrane
• Any complications or unexpected findings
• Post-procedure instructions or recommendations
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 25001, it is important to ensure that the procedure is accurately documented and coded. The healthcare provider should use modifier RT (Right side) or LT (Left side) to identify the operated extremity. It is also crucial to follow any specific billing guidelines provided by the payer or insurance company.

8. Historical information

CPT 25001 was added to the Current Procedural Terminology system on January 1, 2002. There have been no updates or changes to the code since its addition.

9. Similar codes to CPT 25001

There are several similar codes to CPT 25001 that describe procedures on the forearm and wrist. These include:

• CPT 25000: Incision, flexor tendon sheath, palm or finger, each tendon
• CPT 25020: Incision, extensor tendon sheath, wrist or hand, each tendon
• CPT 25023: Incision, extensor tendon sheath, wrist or hand, with release of constriction (e.g., trigger finger)
• CPT 25028: Incision, extensor tendon sheath, wrist or hand, with tendon graft (includes obtaining graft)
• CPT 25031: Incision, extensor tendon sheath, forearm and/or wrist, with repair

9. Examples

1. A patient with rheumatoid arthritis undergoes an incision of the flexor tendon sheath in the wrist to alleviate pain and improve mobility.
2. A patient with carpal tunnel syndrome undergoes an incision of the flexor tendon sheath in the wrist to relieve symptoms and enhance hand function.
3. A healthcare provider performs an incision of the flexor tendon sheath in the wrist to address inflammation and adhesions in a patient with a history of wrist injury.
4. An individual with chronic wrist pain undergoes an incision of the flexor tendon sheath to improve range of motion and reduce discomfort.
5. A patient with limited wrist mobility due to an inflammatory condition undergoes an incision of the flexor tendon sheath to restore function and alleviate pain.
6. A healthcare provider performs an incision of the flexor tendon sheath in the wrist to address adhesions and inflammation in a patient with a history of repetitive strain injury.
7. An individual with persistent wrist swelling and discomfort undergoes an incision of the flexor tendon sheath to improve joint mobility and reduce inflammation.
8. A patient with a history of wrist trauma undergoes an incision of the flexor tendon sheath to address scar tissue and improve hand function.
9. An individual with chronic wrist stiffness and pain undergoes an incision of the flexor tendon sheath to enhance range of motion and alleviate discomfort.
10. A healthcare provider performs an incision of the flexor tendon sheath in the wrist to address chronic inflammation and improve hand dexterity in a patient with a connective tissue disorder.