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The procedure described by CPT® Code 25035 involves a surgical incision into the deep bone cortex of the forearm and/or wrist, specifically targeting the radius, ulna, or one of the carpal bones. This intervention is typically performed to address serious conditions such as osteomyelitis, which is an infection of the bone, or a bone abscess, which is a localized collection of pus within the bone. The process begins with an incision through the skin and soft tissue that overlays the infected area, allowing access to the underlying bone. Once the incision is made, the periosteum, which is the dense layer of vascular connective tissue enveloping the bones, is carefully elevated to expose the infected region of the bone cortex. A small section, referred to as a button of cortical bone, is then removed to access the bone marrow beneath. This step is crucial as it alleviates pressure that may have built up due to inflammation in the bone marrow, thereby restoring blood flow to the affected area. In cases where pus is present, the initial incision may be enlarged using specialized instruments such as a chisel or gouge, extending the opening along the bone for a distance of one to two inches to ensure complete drainage of the abscess. If the infection has spread to the epiphysis, a portion of the epiphyseal cortex may also be excised to facilitate thorough treatment of the infection. Overall, this procedure is essential for managing severe bone infections and preventing further complications.
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The procedure associated with CPT® Code 25035 is indicated for specific conditions that affect the bone cortex of the forearm and/or wrist. These indications include:
The procedure for CPT® Code 25035 involves several critical steps to ensure effective treatment of the infected bone. These steps include:
Post-procedure care following the incision into the bone cortex is critical for recovery. Patients may require monitoring for signs of infection or complications. Pain management will be addressed, and the surgical site will need to be kept clean and dry to promote healing. Follow-up appointments will be necessary to assess the healing process and ensure that the infection has been adequately resolved. Rehabilitation may also be recommended to restore function and strength to the affected limb.
| Short Descr | TREAT FOREARM BONE LESION | Medium Descr | INCISION DEEP BONE CORTEX FOREARM&/WRIST | Long Descr | Incision, deep, bone cortex, forearm and/or wrist (eg, osteomyelitis or bone abscess) | 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) | 0 - 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 | 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) | P5B - Ambulatory procedures - musculoskeletal | MUE | 2 | CCS Clinical Classification | 161 - Other OR therapeutic procedures on bone |
This is a primary code that can be used with these additional add-on codes.
| 20700 | Add-on Code MPFS Status: Active Code APC N ASC N1 Manual preparation and insertion of drug-delivery device(s), deep (eg, subfascial) (List separately in addition to code for primary procedure) | 20702 | Add-on Code MPFS Status: Active Code APC N Manual preparation and insertion of drug-delivery device(s), intramedullary (List separately in addition to code for primary procedure) |
| 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. | 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 | F2 | Left 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 |
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| Pre-1990 | Added | Code added. |
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