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The procedure described by CPT® Code 25119 is a synovectomy of the extensor tendon sheath in the wrist, specifically targeting a single compartment while also involving the resection of the distal ulna. This surgical intervention is primarily indicated for the treatment of inflammation of the synovial tissue, which can occur due to various conditions, most notably rheumatoid arthritis. The procedure aims to alleviate pain and restore function by removing the inflamed synovial tissue that surrounds the extensor tendons, which can become thickened and cause discomfort or limited mobility. The surgical approach involves making an incision on the posterior aspect of the wrist to access the affected area. The dorsal retinaculum, a fibrous band that holds the extensor tendons in place, is carefully exposed and incised to allow for further access to the extensor tendon compartment. The procedure not only addresses the synovial inflammation but also includes the resection of the distal ulna, which may be necessary to relieve symptoms and improve wrist function. This comprehensive approach ensures that both the inflamed tissue and any contributing bony structures are managed effectively, promoting better outcomes for the patient.
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The procedure is indicated for the following conditions:
The procedure involves several key steps to ensure effective treatment of the affected area:
Post-procedure care involves monitoring for any signs of complications, such as infection or excessive swelling. Patients are typically advised to follow a rehabilitation program to restore wrist function and strength gradually. Pain management strategies may be implemented, and follow-up appointments are essential to assess healing and recovery progress. The healthcare provider will provide specific instructions regarding activity restrictions and any necessary physical therapy to ensure a successful outcome.
| Short Descr | PARTIAL REMOVAL OF ULNA | Medium Descr | SYNVCT XTNSR TDN SHTH WRST 1 RESCJ DSTL ULNA | Long Descr | Synovectomy, extensor tendon sheath, wrist, single compartment; with resection of distal ulna | 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) | 1 - Co-surgeons could be paid, though supporting documentation is required... | 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) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 142 - Partial excision bone |
| 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). | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 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 |
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| Pre-1990 | Added | Code added. |
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