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Official Description

Tenolysis, flexor or extensor tendon, forearm and/or wrist, single, each tendon

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Tenolysis is a surgical procedure aimed at restoring motion in the wrist, hand, and fingers by addressing the complications caused by scar tissue that develops around flexor or extensor tendons. This procedure is specifically indicated for a single tendon located in the forearm or wrist. The term "tenolysis" refers to the surgical release of tendons that have become adhered to surrounding tissues due to trauma or disease processes, which can significantly impair movement. During the procedure, a surgical incision is made directly over the affected tendon, allowing the surgeon to access the tendon and the surrounding soft tissues. The surgeon carefully dissects these tissues to identify the affected tendon. In cases involving flexor tendons, the surgeon will sever the adhesions that restrict movement. For extensor tendons, particularly at the wrist, the dorsal retinaculum, which is a fibrous band that holds the tendons in place, is opened to facilitate access to the tendon. After the adhesions are lysed, the surgeon evaluates the range of motion to ensure that the procedure has successfully restored mobility. Finally, the surgical wound is meticulously closed in layers, and a dressing is applied to protect the area as it heals. The CPT® code 25295 should be reported for each flexor or extensor tendon that is released from scar tissue during this procedure.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure of tenolysis is indicated for patients who have experienced limitations in wrist, hand, or finger motion due to the formation of scar tissue around flexor or extensor tendons. This condition may arise from various factors, including:

  • Trauma: Injuries that result in tendon damage or disruption can lead to the development of adhesions.
  • Disease Processes: Conditions such as rheumatoid arthritis or other inflammatory diseases can contribute to tendon scarring and adhesion formation.
  • Post-Surgical Complications: Previous surgeries in the wrist or forearm region may result in scar tissue that restricts tendon movement.

2. Procedure

The tenolysis procedure involves several critical steps to ensure the effective release of the affected tendon. These steps include:

  • Step 1: An incision is made over the site of the affected flexor or extensor tendon in the forearm or wrist. This incision allows direct access to the tendon and surrounding tissues.
  • Step 2: The surgeon carefully dissects the soft tissues surrounding the tendon to expose it fully. This dissection is performed with precision to minimize damage to adjacent structures.
  • Step 3: For flexor tendon tenolysis, the surgeon identifies the affected tendon and proceeds to sever the adhesions that have formed around it. This step is crucial for restoring the tendon’s mobility.
  • Step 4: In cases involving extensor tendon tenolysis at the wrist, the dorsal retinaculum is opened to access the affected compartment. The surgeon then lyses the adhesions that are restricting the tendon’s movement.
  • Step 5: After the adhesions have been successfully released, the surgeon evaluates the range of motion of the tendon to ensure that the procedure has achieved its intended goal of restoring mobility.
  • Step 6: The surgical wound is then closed in layers to promote proper healing and minimize the risk of complications. A dressing is applied to protect the incision site.

3. Post-Procedure

Following the tenolysis procedure, patients can expect a recovery period that may involve specific post-operative care. This includes monitoring the surgical site for signs of infection, managing pain, and following rehabilitation protocols to regain strength and mobility in the affected wrist, hand, or fingers. Physical therapy may be recommended to facilitate recovery and improve range of motion. Patients should adhere to their surgeon's instructions regarding activity restrictions and follow-up appointments to ensure optimal healing and functional outcomes.

Short Descr RELEASE WRIST/FOREARM TENDON
Medium Descr TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA
Long Descr Tenolysis, flexor or extensor tendon, forearm and/or wrist, single, each tendon
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) 1 - Statutory payment restriction for assistants at surgery applies 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 9
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).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
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.
RT Right side (used to identify procedures performed on the right side of the body)
LT Left side (used to identify procedures performed on the left side of the body)
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.
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
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.)
SG Ambulatory surgical center (asc) facility service
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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.
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.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
AG Primary physician
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
F1 Left hand, second digit
F2 Left hand, third digit
F3 Left hand, fourth digit
F4 Left hand, fifth digit
F5 Right hand, thumb
F6 Right hand, second digit
F7 Right hand, third digit
F8 Right hand, fourth digit
F9 Right hand, fifth digit
FA Left hand, thumb
GC This service has been performed in part by a resident under the direction of a teaching physician
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
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Pre-1990 Added Code added.
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