How To Use CPT Code 25111

CPT code 25111 describes the excision of a ganglion, a fluid-filled mass, from the wrist to relieve pain or discomfort. 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 25111?

CPT 25111 is used to describe the excision of a ganglion, which is a fluid-filled mass that occurs on the sheath or covering of a tendon in the wrist. This procedure is performed to alleviate pain or discomfort caused by the ganglion. It involves the removal of the ganglion from the underlying structures of the wrist.

2. Official Description

The official description of CPT code 25111 is: ‘Excision of ganglion, wrist (dorsal or volar) primary.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider makes an incision near the wrist joint.
3. The subcutaneous tissues are separated, and the ganglion is isolated.
4. The ganglion is excised from the underlying structures of the wrist.
5. The area is irrigated, checked for bleeding, and any instruments are removed.
6. The incision is closed.

4. Qualifying circumstances

CPT 25111 is performed when a patient presents with a ganglion in the wrist that is causing pain or discomfort. The excision of the ganglion is necessary to alleviate these symptoms. The procedure can be performed on either the dorsal (rear or bottom side) or volar (palm side) of the wrist.

5. When to use CPT code 25111

CPT code 25111 should be used when a ganglion in the wrist is excised as the primary procedure to relieve pain or discomfort. If the ganglion is a recurrent occurrence at the same location, CPT code 25112 should be reported instead.

6. Documentation requirements

To support a claim for CPT 25111, the following documentation is required:

• Patient’s diagnosis of a ganglion in the wrist
• Explanation of the need for excision to relieve pain or discomfort
• Date of the procedure
• Details of the procedure, including the incision, separation of tissues, isolation and excision of the ganglion, irrigation, and closure of the incision
• Confirmation of any instruments removed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 25111, ensure that the procedure is performed as the primary excision of a ganglion in the wrist. If the ganglion is a recurrent occurrence at the same location, report CPT code 25112 instead. There are no specific guidelines regarding reporting CPT 25111 with other codes.

8. Historical information

CPT 25111 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A patient presents with a ganglion on the dorsal side of their wrist, causing pain. The provider performs an excision of the ganglion as the primary procedure to relieve the patient’s symptoms.
2. A patient has a recurrent ganglion on the volar side of their wrist. The provider performs an excision of the ganglion using CPT code 25112.
3. A patient has a ganglion on the dorsal side of their wrist, and the provider performs an excision with exploration of the tendon sheath using CPT code 25115.
4. A patient has a ganglion on the volar side of their wrist, and the provider performs an excision with exploration of the tendon sheath and joint using CPT code 25116.
5. A patient has a ganglion on the dorsal side of their wrist, and the provider performs an excision with exploration of the tendon sheath and joint, as well as synovectomy using CPT code 25118.