How To Use CPT Code 25251

CPT code 25251 describes the removal of a wrist prosthesis that is complicated, including the total wrist. 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 25251?

CPT 25251 is used to describe the removal of a wrist prosthesis that is complicated, including the total wrist. This procedure is typically performed when there is an adverse reaction, infection, or failure of the device. It involves a complicated dissection to remove the previously implanted artificial wrist joint.

2. Official Description

The official description of CPT code 25251 is: ‘Removal of wrist prosthesis complicated, including total wrist.’

3. Procedure

The procedure for CPT code 25251 involves several steps:

1. The patient is appropriately prepped and anesthetized.
2. The provider makes an incision over the wrist joint and widens it to gain access to the joint.
3. The subcutaneous tissue layers, fascia, and joint capsule are retracted to reach the prosthesis.
4. Any infected soft tissues are removed.
5. The provider uses chisels, forceps, or other grasping instruments to carefully remove the prosthetic material from the wrist.
6. The wrist bones are debrided to ensure complete removal of infected material.
7. A drain may be inserted to facilitate drainage.
8. The area is irrigated with antibiotics to prevent infection.
9. Bleeding is checked and controlled if necessary.
10. Any instruments are removed, and the incision is closed.

4. Qualifying circumstances

CPT 25251 is performed when there is a need to remove a wrist prosthesis that is complicated, including the total wrist. This may be due to an adverse reaction, infection, or failure of the device. The procedure requires a complicated dissection, and it is typically performed by a qualified healthcare professional.

5. When to use CPT code 25251

CPT code 25251 should be used when a wrist prosthesis removal procedure is performed, and it meets the criteria for a complicated case, including the total wrist. It is important to ensure that the procedure performed aligns with the description provided by the code.

6. Documentation requirements

To support a claim for CPT 25251, the healthcare professional must document the following information:

• Patient’s diagnosis or reason for the removal of the wrist prosthesis
• Details of the procedure performed, including the approach, instruments used, and any complications encountered
• Any additional procedures performed during the same session
• Any relevant findings or observations during the procedure
• Post-procedure care instructions or recommendations
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT 25251, it is important to ensure that the procedure performed aligns with the description provided by the code. The healthcare professional should also follow the specific billing guidelines provided by the payer. It is important to review the payer’s policies and guidelines to ensure accurate and appropriate billing.

8. Historical information

CPT 25251 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 a previously implanted wrist prosthesis develops an infection, and the healthcare professional performs a complicated removal procedure, including the total wrist.
2. A wrist prosthesis fails to function properly, causing severe pain and limited mobility. The healthcare professional performs a complicated removal procedure, including the total wrist, to address the issue.
3. An individual experiences an adverse reaction to a wrist prosthesis, leading to inflammation and discomfort. The healthcare professional performs a complicated removal procedure, including the total wrist, to alleviate the symptoms.
4. A patient undergoes a wrist prosthesis removal procedure due to a failed device, which requires a complicated dissection and removal of the total wrist prosthesis.
5. A wrist prosthesis becomes dislodged, causing significant discomfort and functional impairment. The healthcare professional performs a complicated removal procedure, including the total wrist, to address the issue.
6. A patient with a previously implanted wrist prosthesis develops an infection, and the healthcare professional performs a complicated removal procedure, including the total wrist, to prevent further complications.
7. An individual experiences an adverse reaction to a wrist prosthesis, leading to severe pain and limited range of motion. The healthcare professional performs a complicated removal procedure, including the total wrist, to improve the patient’s condition.
8. A wrist prosthesis fails to function properly, causing instability and functional limitations. The healthcare professional performs a complicated removal procedure, including the total wrist, to address the issue.
9. A patient undergoes a wrist prosthesis removal procedure due to an adverse reaction, which requires a complicated dissection and removal of the total wrist prosthesis.
10. A wrist prosthesis becomes dislodged, causing significant pain and functional impairment. The healthcare professional performs a complicated removal procedure, including the total wrist, to alleviate the symptoms and restore function.