How To Use CPT Code 25275

CPT 25275 describes the repair of a tendon sheath in the forearm and/or wrist using a free graft. 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 25275?

CPT 25275 is used to describe the repair of a tendon sheath in the forearm and/or wrist using a free graft. This procedure is performed to treat a subluxing extensor carpi ulnaris tendon that causes wrist pain. The provider harvests tissue from the extensor retinaculum and uses it to reconstruct the tendon sheath, providing stability and relieving symptoms.

2. Official Description

The official description of CPT code 25275 is: ‘Repair, tendon sheath, extensor, forearm and/or wrist, with free graft (includes obtaining graft) (eg, for extensor carpi ulnaris subluxation)’

3. Procedure

During the procedure, the patient is appropriately prepped and anesthetized. The provider makes an incision over the extensor carpi ulnaris tendon, being careful to avoid nerve tissue. Tissue is then harvested from the extensor retinaculum, which is used to reconstruct the tendon sheath. The area is irrigated, bleeding is checked, instruments are removed, and the incision is closed.

4. Qualifying circumstances

CPT 25275 is performed on patients with a subluxing extensor carpi ulnaris tendon that causes wrist pain. The procedure is appropriate when conservative treatments have failed to provide relief, and surgical intervention is necessary to restore stability and function to the tendon sheath.

5. When to use CPT code 25275

CPT code 25275 should be used when a provider performs a repair of the extensor tendon sheath in the forearm and/or wrist using a free graft. This code is specifically for cases involving the extensor carpi ulnaris tendon and should not be used for repairs of other tendons or sheaths in the forearm or wrist.

6. Documentation requirements

To support a claim for CPT 25275, the provider must document the following information:

• Patient’s diagnosis of a subluxing extensor carpi ulnaris tendon causing wrist pain
• Details of the procedure, including the incision, tissue graft, and closure
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 25275, ensure that the procedure performed matches the description of the code. It is important to document the medical necessity of the procedure and provide appropriate supporting documentation. CPT code 25275 should not be reported with other codes unless additional procedures were performed that are separately reportable.

8. Historical information

CPT 25275 was added to the Current Procedural Terminology system on January 1, 2002. There have been no updates or changes to the code since its addition.

9. Similar codes to CPT 25275

There are several similar codes to CPT 25275 that involve repair, revision, and/or reconstruction procedures on the forearm and wrist. These include:

• CPT 25260: Repair, extensor tendon, forearm and/or wrist, primary, without free graft
• CPT 25263: Repair, extensor tendon, forearm and/or wrist, secondary, with free graft
• CPT 25274: Repair, tendon sheath, extensor, forearm and/or wrist, with local tissue transfer (eg, for extensor carpi ulnaris subluxation)
• CPT 25280: Reconstruction, tendon sheath, extensor, forearm and/or wrist, with free graft (includes obtaining graft) (eg, for extensor carpi ulnaris subluxation)
• CPT 25492: Revision of tendon sheath, extensor, forearm and/or wrist

9. Examples

1. A patient with a subluxing extensor carpi ulnaris tendon undergoes a repair of the tendon sheath in the forearm using a free graft.
2. A provider performs a repair of the extensor tendon sheath in the wrist with a free graft for a patient with chronic wrist pain.
3. A subluxing extensor carpi ulnaris tendon causing wrist pain is treated with a repair of the tendon sheath in the forearm and wrist using a free graft.
4. A patient with a subluxing extensor carpi ulnaris tendon undergoes a reconstruction of the tendon sheath in the forearm and wrist with a free graft.
5. A provider performs a revision of the extensor tendon sheath in the forearm and wrist for a patient with recurrent subluxation.
6. A repair of the extensor tendon sheath in the forearm and wrist using a free graft is performed for a patient with a traumatic injury.
7. A patient with a subluxing extensor carpi ulnaris tendon undergoes a secondary repair of the tendon sheath in the forearm and wrist with a free graft.
8. A provider performs a reconstruction of the extensor tendon sheath in the forearm and wrist using a free graft for a patient with chronic instability.
9. A revision of the extensor tendon sheath in the forearm and wrist is performed for a patient with limited range of motion.
10. A repair of the extensor tendon sheath in the forearm and wrist using a free graft is performed for a patient with degenerative changes.