How To Use CPT Code 25119

CPT code 25119 describes a surgical procedure called synovectomy, extensor tendon sheath, wrist, single compartment with resection of distal ulna. 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 25119?

CPT 25119 is a code used to describe a surgical procedure known as synovectomy, extensor tendon sheath, wrist, single compartment with resection of distal ulna. In this procedure, the provider makes an incision to expose the extensor tendon and removes the synovial layer from the extensor tendon sheath. Additionally, a portion of the distal ulna near the wrist is excised.

2. Official Description

The official description of CPT code 25119 is: ‘Synovectomy, extensor tendon sheath, wrist, single compartment with resection of distal ulna.’

3. Procedure

During the procedure, the patient is appropriately prepped and anesthetized. The provider makes an incision on the posterior side of the wrist joint and incises the dorsal retinaculum, elevating it as flaps to access the extensor tendons. Care is taken to retract blood vessels and nerves to prevent any damage. The provider then exposes the distal ulna bone on the side of the little finger and excises the lower end of the ulna bone. Next, the provider examines the extensor tendons and removes the synovial layer of the tendon sheaths in a limited area of the wrist region. Finally, the provider closes the skin with sutures.

4. Qualifying circumstances

CPT 25119 is performed on patients who require a synovectomy of the extensor tendon sheath in the wrist, specifically in a single compartment. The procedure may also involve the resection of a portion of the distal ulna near the wrist. This procedure is typically performed to alleviate symptoms and improve function in patients with conditions such as tenosynovitis or other inflammatory conditions affecting the extensor tendon sheath.

5. When to use CPT code 25119

CPT code 25119 should be used when a synovectomy of the extensor tendon sheath in the wrist, involving a single compartment, is performed. It is important to ensure that the procedure also includes the resection of a portion of the distal ulna near the wrist. If these specific criteria are not met, an alternative CPT code may be more appropriate.

6. Documentation requirements

To support a claim for CPT code 25119, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for synovectomy of the extensor tendon sheath
• Specific details of the procedure, including the incision site, exposure of the extensor tendons, excision of the distal ulna, and removal of the synovial layer
• Date of the procedure
• Any additional findings or procedures performed during the surgery
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 25119, it is important to ensure that the procedure performed meets the specific criteria outlined in the code description. The provider should report this code only if the synovectomy of the extensor tendon sheath in the wrist, involving a single compartment, is performed along with the resection of a portion of the distal ulna near the wrist. It is also important to follow any additional guidelines or requirements set forth by the payer or coding guidelines.

8. Historical information

CPT code 25119 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. Similar codes to CPT 25119

There are several similar codes to CPT code 25119 that describe other procedures involving the extensor tendon sheath and wrist. These include:

• CPT 25111: Synovectomy, extensor tendon sheath, wrist, single compartment
• CPT 25112: Synovectomy, extensor tendon sheath, wrist, multiple compartments
• CPT 25115: Synovectomy, extensor tendon sheath, wrist, radical
• CPT 25116: Synovectomy, extensor tendon sheath, wrist, total
• CPT 25118: Synovectomy, extensor tendon sheath, wrist, with tenolysis

9. Examples

1. A patient with tenosynovitis undergoes a synovectomy of the extensor tendon sheath in a single compartment of the wrist, along with the resection of a portion of the distal ulna near the wrist.
2. A patient with an inflammatory condition affecting the extensor tendon sheath in the wrist undergoes a synovectomy of a single compartment, along with the resection of a portion of the distal ulna near the wrist.
3. A patient with chronic wrist pain and limited range of motion undergoes a synovectomy of the extensor tendon sheath in a single compartment, along with the resection of a portion of the distal ulna near the wrist.
4. A patient with a history of trauma to the wrist develops tenosynovitis and undergoes a synovectomy of the extensor tendon sheath in a single compartment, along with the resection of a portion of the distal ulna near the wrist.
5. A patient with rheumatoid arthritis experiences inflammation and swelling in the extensor tendon sheath of the wrist and undergoes a synovectomy of a single compartment, along with the resection of a portion of the distal ulna near the wrist.
6. A patient with a history of repetitive motion injury develops tenosynovitis in the extensor tendon sheath of the wrist and undergoes a synovectomy of a single compartment, along with the resection of a portion of the distal ulna near the wrist.
7. A patient with a ganglion cyst in the extensor tendon sheath of the wrist undergoes a synovectomy of a single compartment, along with the resection of a portion of the distal ulna near the wrist.