How To Use CPT Code 25455

CPT 25455 describes a procedure known as epiphyseal arrest, which involves the use of screws or specialized staples to temporarily pause the growth of the distal radius and ulna near the wrist. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 25455?

CPT 25455 is used to describe a procedure called epiphyseal arrest, which involves the implantation of screws or specialized staples into the epiphyseal area of the distal radius and ulna near the wrist. This procedure temporarily halts the growth of these bones, allowing for the correction of certain conditions or deformities.

2. Official Description

The official description of CPT code 25455 is: ‘Epiphyseal arrest by epiphysiodesis or stapling; distal radius AND ulna.’

3. Procedure

1. The patient is placed under general anesthesia, and tourniquet control is applied.
2. An incision is made over the epiphyseal area of the distal radius at the wrist, with the guidance of fluoroscopy if necessary.
3. The layers of subcutaneous and fascial tissue are reflected, and the periosteum is split to expose the bone.
4. The provider then implants screws or specialized staples onto the epiphysial growth plate of the radius and ulna, typically at a 90-degree angle to the bone.
5. The wound is closed in layers, ensuring proper implantation of the devices, and fluoroscopy may be used for confirmation.
6. A similar procedure may be performed on the distal ulna of the same forearm/wrist area, usually through a different incision.

4. Qualifying circumstances

CPT 25455 is typically performed on patients who require correction of certain conditions or deformities in the distal radius and ulna near the wrist. This procedure is used to temporarily pause the growth of these bones, allowing for the correction of growth discrepancies or angular deformities. It is important to note that this code specifically refers to the procedure performed on both the radius and ulna. If the procedure is performed on either the radius or ulna alone, a different CPT code should be used.

5. When to use CPT code 25455

CPT code 25455 should be used when the provider performs epiphyseal arrest on both the distal radius and ulna near the wrist. This code should not be used if the procedure is performed on either bone individually. It is important to accurately document the procedure and ensure that the patient meets the qualifying circumstances for this code.

6. Documentation requirements

To support a claim for CPT 25455, the provider must document the following information:

• Patient’s diagnosis and the need for epiphyseal arrest
• Details of the procedure, including the use of screws or specialized staples
• Date of the procedure
• Incision site and approach
• Confirmation of proper implantation of devices, potentially with the use of fluoroscopy
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 25455, ensure that the procedure is performed on both the distal radius and ulna near the wrist. This code should not be reported if the procedure is performed on either bone individually. It is important to follow the specific guidelines and documentation requirements for accurate billing. Additionally, consider any applicable modifiers or additional codes that may be necessary to accurately represent the procedure and any related services.

8. Historical information

CPT 25455 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 25455

While there are no specific similar codes to CPT 25455, it is important to note that there are other codes available for procedures involving the radius and ulna in the forearm and wrist area. These codes may be used for different procedures or approaches, depending on the specific circumstances. It is essential to review the code set and documentation guidelines to accurately select the appropriate code for each procedure.

9. Examples

1. A provider performs epiphyseal arrest on the distal radius and ulna near the wrist to correct a growth discrepancy in a pediatric patient.
2. During a surgical procedure, a surgeon utilizes screws to temporarily pause the growth of the distal radius and ulna near the wrist in a patient with an angular deformity.
3. A patient with a congenital condition undergoes epiphyseal arrest on both the radius and ulna to correct a skeletal abnormality.
4. Following a thorough evaluation, a provider determines that epiphyseal arrest on the distal radius and ulna near the wrist is necessary to address a growth discrepancy in an adolescent patient.
5. A surgeon performs epiphyseal arrest on both the radius and ulna near the wrist to correct an angular deformity caused by a previous injury.
6. In a complex case, a provider utilizes specialized staples to temporarily halt the growth of the distal radius and ulna near the wrist in a patient with a rare skeletal condition.
7. A pediatric patient with a congenital disorder undergoes epiphyseal arrest on both the radius and ulna near the wrist to prevent further growth discrepancies.
8. During a surgical procedure, a surgeon implants screws onto the epiphysial growth plate of the distal radius and ulna near the wrist to correct an angular deformity in an adult patient.
9. A provider performs epiphyseal arrest on both the radius and ulna near the wrist to address a growth discrepancy in a young adult patient.
10. In a complex case involving a rare skeletal condition, a surgeon utilizes specialized staples to temporarily pause the growth of the distal radius and ulna near the wrist in a patient requiring correction of an angular deformity.