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The CPT® Code 25085 refers to a surgical procedure known as capsulotomy of the wrist, which is typically performed to address contractures or other conditions affecting the wrist joint. In this procedure, a longitudinal midline incision or a horizontal incision is made over the dorsal aspect of the wrist, chosen based on the specific site of the pathology being treated. The surgeon carefully develops full thickness skin flaps down to the extensor retinaculum, ensuring the protection of critical structures such as the superficial radial nerve, the dorsal sensory branch of the ulnar nerve, and various blood vessels that are located in this area. The extensor retinaculum, which is a fibrous band that holds the tendons of the wrist in place, is incised longitudinally over the third dorsal compartment to gain access to the underlying structures. Depending on the area that requires exposure, additional steps may involve retracting the extensor pollicis longus muscle or elevating the fourth extensor compartment to facilitate access to the ulnar aspect of the wrist. Conversely, if the radial aspect needs to be accessed, the extensor retinaculum is elevated off Lister's tubercle, and the second dorsal compartment is released. The procedure may also involve incising specific ligaments, such as the dorsal radioulnar ligament for ulnar capsulotomy or the dorsal radiocarpal and intercarpal ligaments for radial capsulotomy, in alignment with their fibers. Ultimately, the wrist capsule is incised, and any adhesions present are released to restore mobility. The surgical wound is then meticulously closed in layers to promote healing and minimize complications.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure of capsulotomy of the wrist (CPT® Code 25085) is indicated for various conditions that may lead to restricted movement or pain in the wrist joint. The following are the explicitly provided indications for performing this procedure:
The capsulotomy procedure involves several detailed steps to ensure effective access and treatment of the wrist joint. The following procedural steps are outlined:
After the capsulotomy procedure, patients can expect a recovery period that may involve pain management and rehabilitation to restore wrist function. Post-operative care typically includes monitoring for any signs of infection, managing swelling, and following a prescribed physical therapy regimen to regain mobility and strength in the wrist. The specific recovery timeline may vary based on the individual patient's condition and the extent of the surgery performed. It is essential for patients to adhere to follow-up appointments to assess healing and progress.
| Short Descr | INCISION OF WRIST CAPSULE | Medium Descr | CAPSULOTOMY WRIST | Long Descr | Capsulotomy, wrist (eg, contracture) | 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 | 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 | 1 | CCS Clinical Classification | 150 - Division of joint capsule, ligament or cartilage |
| 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). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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.) | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | 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) | 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 |
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| Pre-1990 | Added | Code added. |
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