How To Use CPT Code 25800

CPT 25800 describes a surgical procedure known as arthrodesis, which involves fusing the joints of the wrist without the use of a bone graft. This article will provide a comprehensive overview of CPT code 25800, 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 25800?

CPT 25800 is used to describe a surgical procedure called arthrodesis, specifically for the wrist. This procedure involves fusing the joints of the wrist together without the use of a bone graft. It is typically performed to provide pain relief, restore skeletal stability, and improve alignment in patients with advanced arthritis or other conditions affecting the wrist joints.

2. Official Description

The official description of CPT code 25800 is: ‘Arthrodesis, wrist; complete, without bone graft (includes radiocarpal and/or intercarpal and/or carpometacarpal joints).’ This code encompasses the complete fusion of the wrist joints, including the radiocarpal, intercarpal, and carpometacarpal joints, without the use of a bone graft.

3. Procedure

1. Before the procedure, the patient is appropriately prepped and anesthetized to ensure their comfort and safety.
2. The provider makes a straight, longitudinal incision over the affected wrist joint, which may be the radiocarpal, intercarpal, or carpometacarpal joint.
3. Tendons are retracted as necessary, and ligaments are opened to expose the articular surfaces that will be fused.
4. The provider then fuses the joints together, ensuring proper alignment and stability.
5. In some cases, a lag screw may be inserted through the joint to prevent ulnar deviation and ulnar impaction syndrome.
6. The incision and overlying skin are closed using sutures.

4. Qualifying circumstances

CPT 25800 is typically performed on patients with advanced arthritis or other conditions affecting the wrist joints. The procedure is intended to provide pain relief, restore skeletal stability, and improve alignment. It is important to note that this code specifically refers to arthrodesis without the use of a bone graft.

5. When to use CPT code 25800

CPT code 25800 should be used when a complete fusion of the wrist joints is performed without the use of a bone graft. It is important to ensure that the procedure meets the specific criteria outlined in the official description. If a bone graft is used during the arthrodesis procedure, a different CPT code should be used to accurately reflect the nature of the surgery.

6. Documentation requirements

When documenting a claim for CPT code 25800, the following information should be included:

• Patient’s diagnosis and the need for wrist joint fusion
• Details of the procedure, including the specific joints fused and the absence of a bone graft
• Date of the surgery
• Any additional procedures or techniques used during the surgery
• Post-operative care instructions, if applicable
• Signature of the provider performing the surgery

7. Billing guidelines

When billing for CPT code 25800, it is important to ensure that the procedure performed meets the criteria outlined in the official description. Additionally, consider the following billing guidelines:

• Do not report CPT code 25800 if a bone graft was used during the arthrodesis procedure.
• Be aware of any specific payer requirements or guidelines for reporting CPT code 25800.
• Consider using appropriate modifiers, if necessary, to indicate any unique circumstances or additional procedures performed.

8. Historical information

CPT code 25800 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. Examples

1. A patient with advanced arthritis undergoes wrist joint fusion without a bone graft to alleviate pain and improve stability.
2. A professional athlete sustains a severe wrist injury and requires complete fusion of the wrist joints to restore skeletal stability and allow for proper healing.
3. A patient with a congenital wrist deformity undergoes arthrodesis to improve alignment and functionality.
4. A patient with a history of failed wrist joint replacement surgery opts for wrist fusion without a bone graft to address ongoing pain and instability.
5. A patient with rheumatoid arthritis undergoes wrist joint fusion to manage pain and prevent further joint damage.
6. A patient with a traumatic wrist injury undergoes arthrodesis to restore stability and promote proper healing.
7. A patient with a chronic wrist condition that has not responded to conservative treatments undergoes wrist joint fusion to alleviate pain and improve functionality.
8. A patient with a history of wrist instability undergoes arthrodesis to restore stability and prevent future dislocations.
9. A patient with a degenerative wrist condition undergoes wrist joint fusion to improve alignment and alleviate pain.
10. A patient with a wrist joint infection undergoes arthrodesis to eradicate the infection and restore functionality.