How To Use CPT Code 25170

CPT code 25170 describes the radical resection of a tumor in the radius or ulna bones of the arm, including the removal of surrounding healthy tissues to ensure complete removal of the diseased tissue. 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 25170?

CPT 25170 is used to describe the surgical procedure of radical resection of a tumor in the radius or ulna bones of the arm. During this procedure, the provider removes the tumor along with some of the surrounding healthy tissues to ensure that no diseased bony or soft tissue is left in the area.

2. Official Description

The official description of CPT code 25170 is: ‘Radical resection of tumor, radius or ulna.’

3. Procedure

During the procedure, the patient is appropriately prepped and anesthetized. The provider makes an incision over the tumor area of the radius or ulna and brings the incision down through the muscles to expose the bone. The periosteum, a dense layer of vascular connective tissue enveloping the bones, is then retracted to access the tumor. The provider excises the tumor in its entirety, along with any diseased soft tissue. Additionally, nearby healthy bone and soft tissues, such as tendons or muscles, may also be excised. After confirming the complete removal of affected structures, the provider places the periosteum back on the bone surface and uses nearby muscles to provide stability to the joint. The site is irrigated, repaired with sutures, and a drain may be placed if necessary.

4. Qualifying circumstances

CPT 25170 is performed on patients with tumors in the radius or ulna bones of the arm. The procedure is indicated when the tumor requires radical resection, meaning the complete removal of the tumor along with surrounding healthy tissues. The patient must meet the criteria for the procedure, and the provider must determine that the tumor cannot be adequately treated with less extensive surgical methods.

5. When to use CPT code 25170

CPT code 25170 should be used when a provider performs a radical resection of a tumor in the radius or ulna bones of the arm. It is important to ensure that the procedure meets the criteria for radical resection and that the tumor cannot be adequately treated with less extensive surgical methods.

6. Documentation requirements

To support a claim for CPT 25170, the provider must document the following information:

• Patient’s diagnosis and the need for radical resection of the tumor
• Details of the procedure, including the incision, excision of the tumor and surrounding tissues, and any additional procedures performed
• Date and duration of the procedure
• Confirmation of complete removal of affected structures
• Details of any repairs or additional interventions performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 25170, ensure that the procedure meets the criteria for radical resection of a tumor in the radius or ulna bones. It is important to accurately document the details of the procedure and any additional interventions performed. Follow the appropriate coding guidelines and modifiers as required by the payer.

8. Historical information

CPT 25170 was added to the Current Procedural Terminology system on January 1, 1990. The code has not undergone any updates or changes since its addition.

9. Similar codes to CPT 25170

There are several similar codes to CPT 25170 that describe excision procedures on the forearm and wrist. These codes include:

• CPT 25065: Excision, tumor, soft tissue of forearm and/or wrist area; subcutaneous
• CPT 25066: Excision, tumor, soft tissue of forearm and/or wrist area; subfascial (eg, intramuscular)
• CPT 25075: Excision, tumor, soft tissue of forearm and/or wrist area; deep
• CPT 25240: Excision, tumor, bone of forearm and/or wrist area

9. Examples

1. A patient undergoes radical resection of a tumor in the radius bone of the arm.
2. A provider performs radical resection of a tumor in the ulna bone of the arm.
3. A patient with a tumor in both the radius and ulna bones undergoes radical resection of the tumors.
4. A provider performs radical resection of a tumor in the radius bone, along with excision of surrounding soft tissues.
5. A patient undergoes radical resection of a tumor in the ulna bone, with excision of nearby healthy bone and soft tissues.
6. A provider performs radical resection of a tumor in the radius bone, followed by repair of the area with sutures.
7. A patient undergoes radical resection of a tumor in the ulna bone, with the placement of a drain to aid in healing.
8. A provider performs radical resection of a tumor in the radius bone, along with the use of nearby muscles to provide stability to the joint.
9. A patient undergoes radical resection of a tumor in the ulna bone, with confirmation of complete removal of affected structures.
10. A provider performs radical resection of a tumor in the radius bone, followed by irrigation of the surgical site.