How To Use CPT Code 25100

CPT code 25100 describes the procedure of arthrotomy, specifically in the wrist joint, with a biopsy. 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 25100?

CPT 25100 is a code used to describe the arthrotomy procedure in the wrist joint, which includes the extraction of a biopsy. This procedure involves making an incision into the wrist joint to gain access to its interior and taking a tissue sample for further analysis.

2. Official Description

The official description of CPT code 25100 is: ‘Arthrotomy, wrist joint with biopsy.’

3. Procedure

1. The patient is appropriately prepped and anesthetized for the procedure.
2. The provider makes an incision over the dorsal surface of the wrist joint.
3. The provider uses dissection techniques to visualize the joint capsule.
4. The joint capsule is incised to expose the joint.
5. A biopsy of the tissue from inside the joint is taken for analysis.
6. The surgical wound is closed.

4. Qualifying circumstances

CPT 25100 is typically performed in cases of recurrent infection or inflammation in the wrist joint. The procedure is indicated when there is a need to obtain a tissue sample from inside the joint for further analysis. The patient must meet the criteria for the procedure, and the provider must determine that it is medically necessary.

5. When to use CPT code 25100

CPT code 25100 should be used when the provider performs an arthrotomy procedure in the wrist joint and takes a biopsy of the tissue from inside the joint. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 25100, the provider must document the following information:

• Indication for the procedure, such as recurrent infection or inflammation
• Details of the incision made over the dorsal surface of the wrist joint
• Visualization of the joint capsule and incision of the capsule
• Extraction of the tissue biopsy from inside the joint
• Closure of the surgical wound
• Any additional relevant details or findings during the procedure

7. Billing guidelines

When billing for CPT 25100, ensure that the procedure performed meets the specific criteria outlined in the code description. It is important to accurately document and code the procedure to ensure proper reimbursement. There are no specific guidelines regarding reporting CPT code 25100 with other codes.

8. Historical information

CPT code 25100 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with recurrent wrist joint infection undergoes arthrotomy with biopsy to determine the cause of the infection.
2. A patient with chronic wrist joint inflammation undergoes arthrotomy with biopsy to assess the underlying pathology.
3. A patient with suspected wrist joint tumor undergoes arthrotomy with biopsy for further evaluation.
4. A patient with persistent wrist joint pain undergoes arthrotomy with biopsy to investigate the source of the pain.
5. A patient with a history of wrist joint trauma undergoes arthrotomy with biopsy to assess the extent of the damage.
6. A patient with suspected wrist joint infection undergoes arthrotomy with biopsy to confirm the diagnosis.
7. A patient with recurrent wrist joint swelling undergoes arthrotomy with biopsy to identify the underlying cause.
8. A patient with suspected wrist joint arthritis undergoes arthrotomy with biopsy to evaluate the severity of the condition.
9. A patient with persistent wrist joint stiffness undergoes arthrotomy with biopsy to determine the cause of the stiffness.
10. A patient with suspected wrist joint synovitis undergoes arthrotomy with biopsy for further investigation.