How To Use CPT Code 25820

CPT 25820 describes a surgical procedure known as arthrodesis, which involves the fusion of a limited portion of the wrist joint. This article will provide a comprehensive overview of CPT code 25820, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 25820?

CPT 25820 is a code used to describe a specific surgical procedure called arthrodesis. This procedure involves the fusion of a limited portion of the wrist joint without the use of bone grafts. The goal of this procedure is to reduce pain by surgically immobilizing the affected joint while preserving as much motion as possible.

2. Official Description

The official description of CPT code 25820 is: ‘Arthrodesis, wrist; limited, without bone graft (e.g., intercarpal or radiocarpal).’ This code specifically refers to the fusion of a limited portion of the wrist joint without the use of bone grafts.

3. Procedure

1. The provider begins by making an incision in the skin over the back of the wrist, starting from the proximal part of the hand’s metacarpal to the distal end of the forearm.
2. They then dissect through the subcutaneous tissue, carefully preserving the nerves and veins.
3. The wrist capsule is dissected, creating two flaps that allow the provider to open the wrist like a window.
4. The rear rim of the radius is resected and decorticated, meaning a portion of the proximal carpal bones is removed.
5. The provider then fuses the painful radiocarpal joint using techniques such as K-wires, powered staples, or headless screws to restrict movement and alleviate pain.
6. If necessary, the provider may also fuse the intercarpal joints.
7. Hemostasis is achieved at the surgical site, and the wound is closed by suturing the soft tissue in layers.
8. Finally, the joint is placed in a long arm cast for a period of four to six weeks to facilitate proper healing.

4. Qualifying circumstances

CPT 25820 is typically performed on patients who experience significant pain and dysfunction in a limited portion of the wrist joint. This procedure may be indicated for conditions such as arthritis, trauma, or other wrist joint disorders that have not responded to conservative treatments. It is important to note that the fusion is performed without the use of bone grafts.

5. When to use CPT code 25820

CPT code 25820 should be used when a provider performs a limited wrist joint fusion without the use of bone grafts. It is important to ensure that the procedure aligns with the official description of the code. If bone grafts are used or if a different portion of the wrist joint is fused, a different CPT code may be more appropriate.

6. Documentation requirements

When reporting CPT code 25820, the provider must document the following information:

• Patient’s diagnosis and the need for wrist joint fusion
• Details of the procedure, including the specific portion of the wrist joint fused
• Date of the procedure
• Any additional procedures performed during the same surgical session
• Any complications or unexpected findings
• Postoperative care instructions
• Signature of the performing provider

7. Billing guidelines

When billing for CPT code 25820, it is important to ensure that the procedure aligns with the official description and documentation requirements. Additionally, it is crucial to follow any specific billing guidelines provided by the payer. It is also important to note that CPT code 25820 should not be reported if bone grafts are used or if a different portion of the wrist joint is fused. Proper coding and documentation are essential to ensure accurate reimbursement for the procedure.

8. Historical information

CPT code 25820 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 severe arthritis in the radiocarpal joint undergoes arthrodesis of the wrist to alleviate pain and improve function.
2. A trauma patient with a non-healing fracture in the intercarpal joint undergoes limited wrist joint fusion to promote proper healing and stability.
3. A patient with a chronic wrist joint instability undergoes arthrodesis of the midcarpal joint to restore stability and reduce pain.
4. A patient with a failed previous wrist joint surgery undergoes complete wrist arthrodesis with bone graft to achieve fusion and alleviate pain.
5. A patient with a degenerative joint disease in multiple wrist joints undergoes complete wrist arthrodesis without bone graft to improve overall wrist function.
6. A patient with a history of failed conservative treatments for wrist joint pain undergoes limited wrist joint fusion to provide long-term pain relief.
7. A patient with a traumatic injury resulting in severe wrist joint instability undergoes complete wrist arthrodesis with bone graft to restore stability and function.
8. A patient with a chronic wrist joint infection undergoes limited wrist joint fusion to eradicate the infection and promote healing.
9. A patient with a congenital wrist joint deformity undergoes complete wrist arthrodesis without bone graft to correct the deformity and improve function.
10. A patient with a history of recurrent wrist joint dislocations undergoes limited wrist joint fusion to prevent further dislocations and improve stability.