How To Use CPT Code 25332

CPT code 25332 describes the surgical procedure known as arthroplasty of the 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 25332?

CPT 25332 is a code used to describe the surgical procedure of arthroplasty of the wrist. This procedure involves the excision of diseased cartilage and bone sections of the distal radius and carpal bones of the wrist. The provider may also affix a metal implant or fixation devices to provide stability to the joint or reposition the radius and carpal bones and stabilize them using nearby soft tissues.

2. Official Description

The official description of CPT code 25332 is: ‘Arthroplasty, wrist, with or without interposition, with or without external or internal fixation.’

3. Procedure

During the arthroplasty of the wrist procedure, the provider begins by making an incision over the dorsal surface of the hand from the middle of the hand to a little beyond the hand on the forearm. The incision is then extended through the muscles to expose the affected joint area. The provider may choose different approaches to treat the painful and stiff wrist joint caused by arthritic changes.

One approach involves cutting the distal end of the radius and carpal bones and replacing them with artificial metal implants. Another approach involves performing an extensive synovectomy, realigning the area between the distal radius and carpal bones, and fixing the structures with screws and plates. The provider may also choose to perform interposition of the wrist by creating a space between the distal radius and carpal bones and filling the space with nearby tendons and muscles.

At the end of the surgery, the provider irrigates the area with antibiotics and closes it in layers. They may also place a splint or other external fixation device to immobilize the joint for better soft tissue healing.

4. Qualifying circumstances

CPT 25332 is typically performed on patients with arthritic changes in the wrist joint that cause pain and stiffness. The procedure is indicated when other conservative treatments have failed to provide relief. The provider must assess the patient’s condition and determine the need for arthroplasty of the wrist. It is important to note that CPT 25332 may not be appropriate for all patients, and the decision to perform the procedure should be based on the individual patient’s circumstances and medical history.

5. When to use CPT code 25332

CPT code 25332 should be used when the provider performs arthroplasty of the wrist, either with or without interposition, and with or without external or internal fixation. It is important to accurately document the specific details of the procedure to support the use of this code.

6. Documentation requirements

To support a claim for CPT 25332, the provider must document the following information:

• Patient’s diagnosis and the need for arthroplasty of the wrist
• Details of the procedure performed, including whether interposition was used and whether external or internal fixation was performed
• Date of the surgery
• Incision site and approach used
• Specific structures involved in the surgery
• Any additional procedures performed during the same surgical session
• Post-operative care instructions
• Signature of the provider

7. Billing guidelines

When billing for CPT 25332, ensure that the procedure performed meets the criteria described in the official description. It is important to accurately document the details of the procedure to support the use of this code. If additional procedures were performed during the same surgical session, they should be reported separately using the appropriate CPT codes.

8. Historical information

CPT 25332 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Similar codes to CPT 25332

There are several similar codes to CPT 25332 that describe other procedures on the forearm and wrist. These include:

• CPT 25260: Arthroplasty, interposition, intercarpal or carpometacarpal joints
• CPT 25265: Arthroplasty, interposition, intercarpal or carpometacarpal joints; with prosthetic implant
• CPT 25270: Arthroplasty, interposition, intercarpal or carpometacarpal joints; with tendon graft (includes obtaining graft)
• CPT 25400: Arthroplasty, interphalangeal joint; each joint
• CPT 25405: Arthroplasty, interphalangeal joint; with prosthetic implant

9. Examples

1. A patient with severe wrist arthritis undergoes arthroplasty of the wrist to relieve pain and improve joint function.
2. A provider performs arthroplasty of the wrist with interposition using nearby tendons and muscles to create a space between the distal radius and carpal bones.
3. A patient with a history of wrist trauma undergoes arthroplasty of the wrist with internal fixation to stabilize the joint.
4. A provider performs arthroplasty of the wrist with external fixation to provide stability to the joint following the excision of diseased cartilage and bone sections.
5. A patient with rheumatoid arthritis undergoes arthroplasty of the wrist with interposition and prosthetic implant to improve joint function.
6. A provider performs arthroplasty of the wrist on a patient with limited wrist mobility due to previous injuries.
7. A patient with chronic wrist pain undergoes arthroplasty of the wrist with interposition and tendon graft to improve joint stability.
8. A provider performs arthroplasty of the wrist on a patient with degenerative joint disease to alleviate pain and improve range of motion.
9. A patient with a history of failed conservative treatments for wrist arthritis undergoes arthroplasty of the wrist with interposition and external fixation.
10. A provider performs arthroplasty of the wrist on a patient with post-traumatic arthritis to restore joint function and alleviate pain.