© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 25440 pertains to the surgical repair of a nonunion of the scaphoid carpal bone, also known as the navicular bone. A nonunion occurs when the fracture fragments fail to heal properly after an adequate period, leading to persistent pain and dysfunction in the wrist. This condition is particularly significant in the scaphoid bone due to its critical role in wrist stability and movement. The procedure may also involve a radial styloidectomy, which is the surgical removal of the radial styloid process, a bony prominence at the distal end of the radius that can cause mechanical pain by impinging on the scaphoid bone. The surgical approach typically involves making an incision on the posterior aspect of the wrist to access the scaphoid bone directly. During the operation, the surgeon evaluates the nonunion site, removes any scar tissue, and prepares the bone for grafting. A local bone graft is harvested from the radius to facilitate the healing of the scaphoid. The procedure includes the use of internal fixation methods, such as pins or wires, to stabilize the bone fragments and the graft, ensuring proper alignment and support during the healing process. This comprehensive approach aims to restore function and alleviate pain associated with scaphoid nonunion.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 25440 is indicated for patients who exhibit a nonunion of the scaphoid bone, which is characterized by the failure of the fracture to heal after an adequate healing period. This condition may present with the following symptoms or indications:
The surgical procedure for repairing a nonunion of the scaphoid bone involves several critical steps, which are detailed as follows:
After the surgical procedure, patients typically require a period of immobilization to allow for proper healing of the scaphoid bone and the graft. This may involve the use of a cast or splint to restrict movement and provide support. Patients are monitored for signs of complications, such as infection or failure of the graft to integrate. Rehabilitation may be initiated once the initial healing phase is complete, focusing on restoring range of motion and strength in the wrist. Follow-up imaging may be necessary to assess the healing progress of the scaphoid bone and ensure that the nonunion has been successfully addressed.
| Short Descr | REPAIR NONU SCPHD CARPL B1 | Medium Descr | RPR NONUNION SCAPHOID CARPAL B1 W/WO RDL STYLODC | Long Descr | Repair of nonunion, scaphoid carpal (navicular) bone, with or without radial styloidectomy (includes obtaining graft and necessary fixation) | 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 | 148 - Other fracture and dislocation procedure |
| 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. | 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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| 2025-01-01 | Changed | Short and Medium Descriptions changed. |
| 2002-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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