How To Use CPT Code 25320

CPT code 25320 describes a procedure known as capsulorrhaphy or reconstruction of the wrist joint. 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 25320?

CPT 25320 is a code used to describe the capsulorrhaphy or reconstruction of the wrist joint. This procedure is performed to repair the joint capsule, ligaments, and tendons in order to restore stability to the wrist. It is typically done in cases of carpal instability caused by arthritis, inflammatory conditions, or prior trauma.

2. Official Description

The official description of CPT code 25320 is: ‘Capsulorrhaphy or reconstruction, wrist, open (eg, capsulodesis, ligament repair, tendon transfer or graft) (includes synovectomy, capsulotomy and open reduction) for carpal instability.’

3. Procedure

The capsulorrhaphy or reconstruction of the wrist joint involves several steps:

1. The patient is appropriately prepped and anesthetized.
2. The provider makes an incision in the wrist to expose the carpal bones.
3. The joint capsule is repaired, and any necessary synovial membrane is excised.
4. The involved carpal bones are reduced and stabilized with multiple pins.
5. Tendon graft strips, usually harvested from the long extensor tendons of the wrist, are passed through carpal bone tunnels to reconstruct the injured ligaments.
6. The area is irrigated, checked for bleeding, and any instruments are removed.
7. The incision is closed, and a cast is applied to support the wrist during the healing process.

4. Qualifying circumstances

CPT code 25320 is used for patients with carpal instability caused by arthritis, inflammatory conditions, or prior trauma. The procedure is performed by a qualified healthcare professional and involves the repair of the joint capsule, ligaments, and tendons in the wrist.

5. When to use CPT code 25320

CPT code 25320 should be used when performing capsulorrhaphy or reconstruction of the wrist joint for carpal instability. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT code 25320, the healthcare professional must document the following information:

• Patient’s diagnosis of carpal instability
• Details of the procedure performed, including repair of the joint capsule, ligaments, and tendons
• Date of the procedure
• Start and end time of the procedure
• Any additional procedures performed, such as synovectomy, capsulotomy, or open reduction
• Any complications or unexpected findings during the procedure
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT code 25320, ensure that the procedure meets the specific criteria outlined in the code description. It is important to follow the appropriate coding guidelines and modifiers, if applicable. Additionally, be aware of any bundling or unbundling issues that may affect the billing of this code.

8. Historical information

CPT code 25320 was added to the Current Procedural Terminology system on January 1, 1990. There have been historical changes to the code, including a code change on January 1, 2003, which expanded the description to include any method of capsulorrhaphy or reconstruction for carpal instability.

9. Examples

1. A patient with carpal instability undergoes capsulorrhaphy and reconstruction of the wrist joint to repair the joint capsule, ligaments, and tendons.
2. A patient with arthritis in the wrist undergoes capsulorrhaphy and reconstruction to restore stability and alleviate pain.
3. A patient with a history of trauma to the wrist undergoes capsulorrhaphy and reconstruction to repair the damaged joint structures.
4. A patient with an inflammatory condition affecting the wrist undergoes capsulorrhaphy and reconstruction to improve joint stability and function.
5. A patient with recurrent dislocations of the wrist undergoes capsulorrhaphy and reconstruction to prevent further instability.
6. A patient with chronic wrist pain undergoes capsulorrhaphy and reconstruction to address the underlying cause of the pain.
7. A patient with limited wrist mobility undergoes capsulorrhaphy and reconstruction to improve range of motion.
8. A patient with a failed previous wrist surgery undergoes capsulorrhaphy and reconstruction to correct the previous procedure’s complications.
9. A patient with a congenital wrist deformity undergoes capsulorrhaphy and reconstruction to improve wrist function and appearance.
10. A patient with a sports-related wrist injury undergoes capsulorrhaphy and reconstruction to restore joint stability and allow for a return to physical activity.