How To Use CPT Code 25272

CPT code 25272 describes the repair of an extensor tendon or muscle in the forearm or wrist, which is performed after the passage of time from the original traumatic injury. 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 25272?

CPT 25272 is used to describe the repair of an extensor tendon or muscle in the forearm or wrist. This procedure is performed after a certain period of time has passed since the initial traumatic injury. The repair involves incising the skin over the affected tendon or muscle, repairing the injured tissue, and performing tenosynovectomy if necessary.

2. Official Description

The official description of CPT code 25272 is: ‘Repair, tendon or muscle, extensor, forearm and/or wrist secondary, single, each tendon or muscle.’

3. Procedure

The procedure for CPT code 25272 involves the following steps:

1. The patient is appropriately prepped and anesthetized.
2. The provider makes an incision in the skin over the affected tendon or muscle.
3. The provider deepens the incision, taking care to avoid nerve tissue.
4. The injured muscle or tendon is repaired.
5. Tenosynovectomy is performed if necessary.
6. The area is irrigated, checked for bleeding, and any instruments are removed.
7. The incision is closed.

4. Qualifying circumstances

CPT 25272 is used for the repair of extensor tendons or muscles in the forearm or wrist that have been injured due to trauma. This code is specifically for secondary repairs, meaning that the procedure is performed after a certain period of time has passed since the initial injury. The repair may involve one or multiple tendons or muscles.

5. When to use CPT code 25272

CPT code 25272 should be used when a provider is performing a secondary repair of an extensor tendon or muscle in the forearm or wrist. This code is not appropriate for primary repairs or repairs of other types of tendons or muscles. It is important to accurately document the details of the procedure to support the use of this code.

6. Documentation requirements

To support a claim for CPT 25272, the following documentation is required:

• Patient’s diagnosis and the need for the repair
• Details of the procedure, including the specific tendon or muscle repaired
• Date of the procedure
• Any additional procedures performed, such as tenosynovectomy
• Any complications or unexpected findings
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 25272, ensure that the procedure meets the criteria for a secondary repair of an extensor tendon or muscle in the forearm or wrist. This code should not be reported for primary repairs or repairs of other types of tendons or muscles. It is important to follow the specific guidelines provided by the payer to ensure accurate billing and reimbursement.

8. Historical information

CPT 25272 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 sustains a traumatic injury to their forearm, resulting in a laceration of the extensor tendon. After a period of healing, the provider performs a secondary repair of the extensor tendon using CPT code 25272.
2. A patient fractures their wrist, which also causes damage to the extensor muscles. After the fracture is stabilized, the provider performs a secondary repair of the extensor muscles using CPT code 25272.
3. A patient undergoes a previous repair of an extensor tendon in their forearm, but the repair fails over time. The provider performs a secondary repair of the extensor tendon using CPT code 25272.
4. A patient presents with a chronic extensor tendon injury in their wrist. After conservative treatment fails, the provider performs a secondary repair of the extensor tendon using CPT code 25272.
5. A patient sustains a traumatic injury to their forearm, resulting in damage to multiple extensor tendons. After a period of healing, the provider performs a secondary repair of the extensor tendons using CPT code 25272 for each tendon repaired.