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Surgical arthroscopy of the wrist is a minimally invasive procedure that involves the use of an arthroscope to visualize and treat conditions within the wrist joint. Specifically, this procedure is performed to address infections by allowing for lavage, which is the flushing of the joint with sterile solutions, and drainage, which involves the removal of infected fluid or pus. The patient undergoing this procedure is typically positioned supine, meaning they lie on their back, with the shoulder abducted to facilitate access to the wrist. A pneumatic tourniquet is applied to the upper arm to minimize blood flow to the area, enhancing visibility and control during the procedure. To further aid in visualization, the forearm is suspended in a wrist traction device, and weights are applied to the second and third fingers, creating distraction in the wrist joint. This distraction allows the surgeon to better see the joint structures and perform the necessary interventions. The procedure involves making small incisions, or portals, in the skin over the wrist to introduce the arthroscope and other surgical instruments. Through these portals, the surgeon can effectively drain the infected material and flush the joint with sterile saline or an antibiotic solution, ensuring thorough cleaning of the infected area. Additional incisions may be made as needed to access other parts of the wrist joint, such as the midcarpal joint, to ensure complete drainage and lavage. After the procedure is completed, the instruments are removed, and the incisions are closed, allowing for a quicker recovery compared to traditional open surgery.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure is indicated for the treatment of infections within the wrist joint. This may include conditions where there is the presence of pus or other infectious material that requires surgical intervention to prevent further complications and to promote healing.
The surgical procedure begins with the patient being placed in a supine position, which allows for optimal access to the wrist. The shoulder is abducted to facilitate the necessary positioning. A pneumatic tourniquet is then applied to the upper arm to restrict blood flow, which helps to minimize bleeding and improve visibility during the procedure. Following this, the forearm is suspended in a wrist traction device, and weights of 7-10 lbs are applied to the second and third fingers. This traction creates distraction in the wrist joint, enhancing the surgeon's ability to visualize the joint structures clearly.
After the procedure, the patient may be monitored for any signs of complications, such as infection or excessive bleeding. Post-operative care typically includes instructions for wound care and pain management. The patient may be advised to limit movement of the wrist to facilitate healing and to follow up with their healthcare provider for further evaluation and management. Recovery time can vary based on the extent of the infection and the individual patient's health status.
| Short Descr | WRIST ARTHROSCOPY/SURGERY | Medium Descr | ARTHROSCOPY WRIST INFECTION LAVAGE&DRAINAGE | Long Descr | Arthroscopy, wrist, surgical; for infection, lavage and drainage | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 3 - Special payment adjustment rules for multiple endoscopic 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. | Endoscopic Base Code | 29840 Arthroscopy, wrist, diagnostic, with or without synovial biopsy (separate 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) | P8A - Endoscopy - arthroscopy | MUE | 1 | CCS Clinical Classification | 149 - Arthroscopy |
| 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. | 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.) | 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 | 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 |
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