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The CPT® Code 25126 refers to the excision or curettage of a bone cyst or benign tumor located in the radius or ulna, specifically excluding the head or neck of the radius and the olecranon process. A bone cyst is defined as a fluid-filled space within the bone, which can vary in type. The unicameral or simple bone cyst is the most common, characterized as a benign lesion. Another type, the aneurysmal bone cyst, is less common and consists of vascular tissue surrounding a blood-filled cystic lesion. Additionally, there are various benign bone tumors, including giant cell tumors, chondromyxoid fibromas, and enchondromas. The procedure involves making an incision over the lesion site in the radial or ulnar shaft or distal radius or ulna, followed by dissection of the soft tissues to expose the lesion. If a cystic lesion is identified, the bone is incised to create a window, allowing for the aspiration of fluid, which is then sent for laboratory analysis. The lining of the cystic cavity is removed through curettage, or the lesion may be excised along with a margin of healthy bone. In this specific code, after the lesion is treated, the resulting defect is filled with donor bone, known as allograft, to promote healing and structural integrity of the bone.
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The procedure associated with CPT® Code 25126 is indicated for the treatment of specific conditions affecting the radius or ulna. These include:
The procedure for CPT® Code 25126 involves several critical steps to ensure effective treatment of the bone cyst or benign tumor:
Post-procedure care for CPT® Code 25126 typically involves monitoring the surgical site for signs of infection and ensuring proper healing of the bone. Patients may be advised to limit weight-bearing activities on the affected limb for a specified period to promote recovery. Follow-up appointments are essential to assess the healing process and the integration of the allograft into the bone. Rehabilitation may be recommended to restore function and strength to the affected area.
| Short Descr | REMOVE/GRAFT FOREARM LESION | Medium Descr | EXC/CURTG CYST/TUMOR RADIUS/ULNA W/ALLOGRAFT | Long Descr | Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process); with allograft | 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 | 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). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | FA | Left hand, thumb | 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 |
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| Pre-1990 | Added | Code added. |
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