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Official Description

Incision, flexor tendon sheath, wrist (eg, flexor carpi radialis)

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 25001 refers to the surgical procedure involving the incision of the flexor tendon sheath at the wrist, specifically targeting tendons such as the flexor carpi radialis. This procedure is typically indicated for conditions like tendonitis or tenosynovitis, which can cause significant pain in the wrist and hand. During the procedure, the surgeon makes an incision in the skin over the affected tendon(s) in the wrist to expose them. Once the tendon(s) are visible, the tendon sheath surrounding the involved tendon or tendons is carefully inspected and incised longitudinally to relieve pressure and alleviate pain. After the necessary surgical intervention is completed, the skin is then closed using sutures. It is important to note that this code is specifically for flexor tendon sheaths; for conditions affecting the extensor tendon sheath, such as de Quervain's disease, a different code (CPT® Code 25000) should be utilized. De Quervain's disease is characterized by painful inflammation of the extensor tendons located on the thumb side of the wrist, necessitating a different surgical approach.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure associated with CPT® Code 25001 is indicated for the following conditions:

  • Tendonitis - Inflammation of the tendon that can cause pain and restrict movement in the wrist and hand.
  • Tenosynovitis - Inflammation of the tendon sheath, leading to pain and swelling, particularly in the wrist area.

2. Procedure

The procedure for CPT® Code 25001 involves several key steps that are performed to address the issues related to the flexor tendon sheath:

  • Step 1: Skin Incision - The surgeon begins by making an incision in the skin over the affected tendon(s) in the wrist. This incision is carefully placed to provide optimal access to the underlying structures while minimizing damage to surrounding tissues.
  • Step 2: Exposure of Tendon(s) - After the skin is incised, the surgeon gently retracts the skin and underlying tissues to expose the tendon(s) that are causing symptoms. This step is crucial for visualizing the tendon sheath and assessing the condition of the tendon.
  • Step 3: Inspection and Incision of the Tendon Sheath - Once the tendon(s) are exposed, the surgeon inspects the tendon sheath for any signs of inflammation or damage. The tendon sheath is then incised longitudinally, which allows for the release of any constriction and alleviates pressure on the tendon, thereby reducing pain and improving function.
  • Step 4: Closure of the Skin - After the necessary surgical intervention on the tendon sheath is completed, the surgeon proceeds to close the skin incision. This is typically done using sutures, ensuring that the incision is properly aligned for optimal healing.

3. Post-Procedure

Post-procedure care for patients undergoing the incision of the flexor tendon sheath includes monitoring for signs of infection, managing pain, and ensuring proper wound care. Patients may be advised to rest the affected wrist and hand to promote healing. Rehabilitation exercises may be recommended to restore mobility and strength once the initial healing phase has passed. Follow-up appointments are essential to assess the recovery process and to determine if any further interventions are necessary.

Short Descr INCISE FLEXOR CARPI RADIALIS
Medium Descr INCISION FLEXOR TENDON SHEATH WRIST
Long Descr Incision, flexor tendon sheath, wrist (eg, flexor carpi radialis)
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) 1 - Statutory payment restriction for assistants at surgery applies 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 Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P5B - Ambulatory procedures - musculoskeletal
MUE 1
CCS Clinical Classification 160 - Other therapeutic procedures on muscles and tendons
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.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
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.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CR Catastrophe/disaster related
F6 Right hand, second digit
F7 Right hand, third digit
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)
SG Ambulatory surgical center (asc) facility service
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2002-01-01 Added First appearance in code book in 2002.
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