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The procedure described by CPT® Code 25263 pertains to the repair of flexor tendons or muscles located in the forearm and/or wrist, specifically addressing secondary repairs for a single tendon or muscle. Flexor tendons and muscles are essential for the movement of the wrist, hand, and fingers, as they facilitate flexion. These structures originate from the medial epicondyle of the humerus and the proximal radius and ulna, and include key muscles such as the flexor carpi radialis, palmaris longus, flexor carpi ulnaris, flexor digitorum superficialis, flexor digitorum profundus, and flexor pollicis longus. Injuries to these tendons and muscles can occur due to both open and closed mechanisms, with lacerations and puncture wounds leading to partial or complete transection of the tendons. Closed injuries, such as avulsions, can also result in damage. The surgical procedure involves making an incision over the site of injury, locating the severed tendon, and performing a suture repair. In cases where primary repair does not yield satisfactory functional results, a secondary repair is indicated, which is what CPT® Code 25263 specifically addresses. This code is utilized when a secondary suture repair is necessary to restore function to the affected tendon or muscle.
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The procedure associated with CPT® Code 25263 is indicated for the following conditions:
The procedure for CPT® Code 25263 involves several critical steps to ensure proper repair of the flexor tendon or muscle:
Post-procedure care following the repair of a flexor tendon or muscle includes monitoring for signs of infection, ensuring proper immobilization of the wrist and hand, and following up with rehabilitation to restore function. Patients may require physical therapy to regain strength and range of motion in the affected area. The duration of immobilization and rehabilitation will depend on the extent of the injury and the specific repair performed. Regular follow-up appointments are essential to assess healing and adjust treatment as necessary.
| Short Descr | REPAIR FOREARM TENDON/MUSCLE | Medium Descr | RPR TDN/MUSC FLXR F/ARM&/WRIST SEC 1 EA TDN/MUS | Long Descr | Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, single, each tendon or muscle | 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) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | 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 | 4 | CCS Clinical Classification | 160 - Other therapeutic procedures on muscles and tendons |
| 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. | 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.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | F3 | Left hand, fourth digit | F4 | Left hand, fifth digit | F5 | Right hand, thumb | F6 | Right hand, second 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) | 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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| 2013-01-01 | Changed | Medium Descriptor changed. |
| Pre-1990 | Added | Code added. |
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