How To Use CPT Code 25335

CPT 25335 describes the surgical procedure known as centralization of the wrist on ulna, which is commonly performed to treat conditions such as radial club hand. This article will provide a comprehensive overview of CPT code 25335, including its official description, the procedure involved, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 25335?

CPT 25335 is a code used to describe the surgical procedure known as centralization of the wrist on ulna. This procedure is typically performed to treat conditions such as radial club hand, which is a congenital anomaly where the radius bone in the forearm is missing or underdeveloped, causing the hand to bend radially or towards the body.

2. Official Description

The official description of CPT code 25335 is: ‘Centralization of wrist on ulna (e.g., radial club hand).’ This code specifically refers to the surgical procedure where the provider centralizes the wrist over the ulna to correct the deformity associated with radial club hand.

3. Procedure

During the centralization of the wrist on ulna procedure, the healthcare provider follows a step-by-step approach to correct the deformity caused by radial club hand:

1. The patient is appropriately prepped and anesthetized.
2. The provider makes an incision in the lower end of the forearm to expose the lower portion of the ulna.
3. The wrist joint capsule is incised, and a slot is created in the carpal bone to adjust the ulna bone.
4. A portion of the lower end of the ulna bone is shaved.
5. A Z-plasty incision is made on the radial side of the forearm to provide extra length to the skin on this side.
6. The provider rebalances the unequal muscle forces by shortening the extensor carpi ulnaris muscle and transferring the deforming radial wrist muscles to the ulnar side of the wrist.
7. A K-wire is used to unite the lower end of the ulna with the carpal and metacarpal bones, aiming to maintain some motion between the ulna and carpal bones.
8. The provider stops bleeding and closes the incision by suturing the layers of tissue together.

4. Qualifying circumstances

CPT 25335 is typically performed on patients with radial club hand, a congenital condition characterized by the absence or underdevelopment of the radius bone in the forearm. The procedure is intended to correct the deformity and centralize the wrist over the ulna. Patients who meet the diagnostic criteria for radial club hand and require surgical intervention may qualify for this procedure.

5. When to use CPT code 25335

CPT code 25335 should be used when the provider performs the centralization of the wrist on ulna procedure to correct the deformity associated with radial club hand. It is important to ensure that the patient meets the diagnostic criteria for radial club hand and that the procedure is performed to centralize the wrist over the ulna.

6. Documentation requirements

To support a claim for CPT code 25335, the healthcare provider must document the following information:

• Patient’s diagnosis of radial club hand
• Description of the procedure performed, including the steps involved
• Date of the procedure
• Any additional details or complications encountered during the procedure
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 25335, it is important to ensure that the procedure performed aligns with the official description of the code. The provider should also follow any specific billing guidelines provided by the payer. It is recommended to review the payer’s policies and guidelines to ensure accurate and appropriate billing for this procedure.

8. Historical information

CPT code 25335 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. Similar codes to CPT 25335

While there are no specific similar codes to CPT code 25335, there are other codes within the range of repair, revision, and/or reconstruction procedures on the forearm and wrist (CPT codes 25260-25492) that may be applicable for different procedures involving the forearm and wrist.

9. Examples

1. A patient with radial club hand undergoes centralization of the wrist on ulna to correct the deformity and improve hand function.
2. A healthcare provider performs the centralization of the wrist on ulna procedure on an infant with bilateral radial club hand.
3. A teenager with radial club hand undergoes surgery to centralize the wrist over the ulna, allowing for improved wrist and hand movement.
4. A young child with radial club hand receives the centralization of the wrist on ulna procedure to address the deformity and promote better hand alignment.
5. A healthcare provider performs the centralization of the wrist on ulna procedure on an adult with long-standing radial club hand to improve wrist stability and function.
6. A patient with radial club hand undergoes surgery to centralize the wrist over the ulna, enabling better grip strength and overall hand function.
7. An individual with radial club hand receives the centralization of the wrist on ulna procedure to correct the deformity and enhance their ability to perform daily activities.
8. A healthcare provider performs the centralization of the wrist on ulna procedure on a child with unilateral radial club hand, aiming to improve wrist alignment and function.
9. A teenager with radial club hand undergoes surgery to centralize the wrist over the ulna, allowing for improved range of motion and hand dexterity.
10. A young adult with radial club hand receives the centralization of the wrist on ulna procedure to address the deformity and enhance their overall hand function.