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The procedure described by CPT® Code 25135 involves the excision or curettage of a bone cyst or a benign tumor located within the carpal bones, which are the eight small bones that form the wrist joint. This surgical intervention is performed to remove non-cancerous growths that may cause discomfort, limit mobility, or lead to other complications. The term 'excision' refers to the surgical removal of tissue, while 'curettage' involves scraping away the abnormal tissue. In this specific procedure, the physician not only removes the cyst or tumor but also repairs the resulting wound using an autograft, which is a bone graft taken from the patient's own body. This approach is essential for promoting healing and restoring the structural integrity of the wrist. It is important to note that if a graft from a donor patient is used instead, CPT® Code 25136 should be applied. The use of an autograft is significant as it typically leads to better integration and healing compared to grafts from other sources.
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The procedure associated with CPT® Code 25135 is indicated for the following conditions:
The procedure for CPT® Code 25135 involves several key steps that ensure the effective removal of the bone cyst or benign tumor while facilitating proper healing through the use of an autograft.
After the procedure, patients are typically monitored for any immediate complications. Post-operative care may include pain management, instructions for wound care, and guidelines for activity restrictions to promote healing. Patients may be advised to avoid weight-bearing activities on the wrist for a specified period to ensure proper recovery. Follow-up appointments are essential to assess the healing process and to remove sutures if necessary. Rehabilitation exercises may also be recommended to restore mobility and strength in the wrist as healing progresses.
| Short Descr | REMOVE & GRAFT WRIST LESION | Medium Descr | EXC/CURTG CYST/TUMOR CARPAL BONES W/AUTOGRAFT | Long Descr | Excision or curettage of bone cyst or benign tumor of carpal bones; with autograft (includes obtaining graft) | 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) | 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.) | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | F7 | Right hand, third digit | 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) |
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| Pre-1990 | Added | Code added. |
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