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The procedure described by CPT® Code 25909 refers to the re-amputation of the forearm through the radius and ulna. This surgical intervention is performed when there is a need to remove diseased, infected, or nonviable tissue that poses a risk to the patient's health. The re-amputation is typically conducted at a higher level than a previous amputation to ensure that a healthy stump is created, which can be utilized for fitting a prosthesis. The process begins with careful planning, where incision lines are marked on the skin to guide the surgical approach. The surgery involves incising the skin and underlying soft tissue, followed by the exposure and isolation of muscle groups. During the procedure, special attention is given to the identification and separation of nerves and blood vessels to prevent any potential complications, such as nerve irritation from pulsatile blood flow. The bones, specifically the radius and ulna, are then exposed, and periosteal flaps are created to facilitate the transection of the bones at the appropriate level. After the bones are cut, the periosteal flaps are sutured over the remaining bone segments to promote healing. Additionally, the antagonistic muscle groups are sutured together and anchored to the periosteum, ensuring that the remaining bone is completely enveloped in muscle tissue. Finally, skin flaps are fashioned and sutured over the muscle to complete the procedure, providing a well-structured and functional stump for potential prosthetic use.
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The re-amputation of the forearm through the radius and ulna, as described by CPT® Code 25909, is indicated in specific clinical scenarios where the integrity of the limb is compromised. The following conditions may warrant this procedure:
The procedure for re-amputation through the radius and ulna involves several critical steps to ensure a successful outcome. Each step is meticulously executed to minimize complications and promote healing.
After the re-amputation procedure, the patient will require careful monitoring and post-operative care to ensure proper healing and recovery. This may include pain management, wound care, and rehabilitation to prepare for potential prosthetic fitting. The surgical site will need to be kept clean and dry, and any signs of infection or complications should be reported to the healthcare provider immediately. Follow-up appointments will be necessary to assess healing and to plan for any further interventions, including prosthetic fitting if indicated.
| Short Descr | AMPUTATION FOLLOW-UP SURGERY | Medium Descr | AMP FOREARM THRU RADIUS&ULNA RE-AMPUTATION | Long Descr | Amputation, forearm, through radius and ulna; re-amputation | 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 | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 164 - Other OR therapeutic procedures on musculoskeletal system |
| 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. | 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.) | 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). | CR | Catastrophe/disaster related | 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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