How To Use CPT Code 25445

CPT 25445 describes the surgical procedure of arthroplasty with prosthetic replacement of the trapezium bone in 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 25445?

CPT 25445 is used to describe the surgical procedure of arthroplasty with prosthetic replacement of the trapezium bone in the wrist. This procedure is typically performed in cases of arthritis of the thumb’s base, where the trapezium bone needs to be replaced with an artificial prosthesis.

2. Official Description

The official description of CPT code 25445 is: ‘Arthroplasty with prosthetic replacement; trapezium.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. A small transverse incision is made on the dorsum of the hand over the thumb base.
3. The incision is extended down to the level of the joint capsule.
4. The blood vessels and nerve tissues are carefully retracted to prevent any damage.
5. The joint capsule is excised, exposing the bony surface while keeping the tendons intact.
6. The trapezium bone is detached from the surrounding soft tissues and removed.
7. An artificial implant made of metal or synthetic material is inserted in place of the trapezium bone.
8. The implant is fixed in place by nailing one side on the trapezoid bone and the other side on the metacarpal of the index finger.
9. Sutures or a pin may be used to further stabilize the implant.
10. The joint capsule and ligaments are sutured back around the joint.
11. The incision is closed in layers, and a drain may be placed if necessary.

4. Qualifying circumstances

CPT 25445 is performed in cases of arthritis of the thumb’s base, where the trapezium bone needs to be replaced with an artificial prosthesis. The procedure is typically performed by a qualified healthcare professional who has the necessary expertise in performing arthroplasty with prosthetic replacement.

5. When to use CPT code 25445

CPT code 25445 should be used when the surgical procedure of arthroplasty with prosthetic replacement of the trapezium bone is performed. 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 25445, the healthcare professional must document the following information:

• Patient’s diagnosis and the need for arthroplasty with prosthetic replacement
• Details of the surgical procedure performed, including the specific steps taken
• Date of the procedure
• Any additional procedures or interventions performed during the same session
• Any complications or unexpected findings
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT 25445, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately report the procedure and any additional services provided during the same session. Follow the appropriate coding guidelines and modifiers, if applicable, to ensure accurate reimbursement.

8. Historical information

CPT 25445 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A patient with severe arthritis of the thumb’s base undergoes arthroplasty with prosthetic replacement of the trapezium bone.
2. A healthcare professional performs arthroplasty with prosthetic replacement of the trapezium bone in a patient with degenerative joint disease.
3. Arthroplasty with prosthetic replacement of the trapezium bone is performed in a patient with traumatic injury to the thumb’s base.
4. A patient with rheumatoid arthritis undergoes arthroplasty with prosthetic replacement of the trapezium bone to alleviate pain and improve thumb function.
5. Arthroplasty with prosthetic replacement of the trapezium bone is performed in a patient with osteoarthritis of the thumb’s base.
6. A healthcare professional performs arthroplasty with prosthetic replacement of the trapezium bone in a patient with thumb joint deformity.
7. A patient with thumb joint instability undergoes arthroplasty with prosthetic replacement of the trapezium bone to restore joint stability.
8. Arthroplasty with prosthetic replacement of the trapezium bone is performed in a patient with thumb joint degeneration due to repetitive use.
9. A healthcare professional performs arthroplasty with prosthetic replacement of the trapezium bone in a patient with thumb joint malalignment.
10. A patient with thumb joint pain and limited range of motion undergoes arthroplasty with prosthetic replacement of the trapezium bone to improve function.