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The procedure described by CPT® Code 25251 involves the surgical removal of a wrist prosthesis that has become complicated. In this context, a wrist prosthesis refers to an artificial device that has been implanted to replace or support the function of the wrist joint. The term "complicated" indicates that the removal process may involve additional challenges, such as the presence of scar tissue, infection, or other complications that can arise from the previous surgery or the condition of the surrounding tissues. The procedure necessitates a careful approach, as the surgeon must make an incision in the wrist area and meticulously dissect through the layers of tissue down to the bone to access and remove the prosthetic device. This procedure is specifically indicated when the entire wrist prosthesis is involved, highlighting the complexity and extent of the surgical intervention required. Proper coding of this procedure is essential for accurate billing and reimbursement, as it reflects the intricacies involved in the surgical removal of a total wrist prosthesis.
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The procedure associated with CPT® Code 25251 is indicated in specific circumstances where complications arise from a previously implanted wrist prosthesis. These indications may include:
The procedure for the removal of a complicated wrist prosthesis, as described by CPT® Code 25251, involves several critical steps:
Post-procedure care following the removal of a complicated wrist prosthesis is crucial for recovery. Patients are typically monitored for signs of infection, bleeding, or other complications. Pain management strategies may be implemented to address discomfort following surgery. Rehabilitation may be necessary to restore function and strength to the wrist, which can include physical therapy exercises. Patients are advised to follow up with their healthcare provider to assess healing and determine the need for any further interventions or adjustments in treatment.
| Short Descr | REMOVAL OF WRIST PROSTHESIS | Medium Descr | REMOVAL WRIST PROSTH COMPLICATED W/TOTAL WRIST | Long Descr | Removal of wrist prosthesis; complicated, including total wrist | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | T-Packaged Codes | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 162 - Other OR therapeutic procedures on joints |
This is a primary code that can be used with these additional add-on codes.
| 20704 | Add-on Code MPFS Status: Active Code APC N Manual preparation and insertion of drug-delivery device(s), intra-articular (List separately in addition to code for primary procedure) | 20705 | Add-on Code MPFS Status: Active Code APC N Removal of drug-delivery device(s), intra-articular (List separately in addition to code for primary procedure) |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) |
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| Pre-1990 | Added | Code added. |
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