Decompression fasciotomy treats compartment syndrome, a painful condition in which pressure

24579 Open treatment of humeral condylar fracture, medial or lateral, includes internal fixation, when performed 24582 Percutaneous skeletal fixation of humeral condylar

fracture, medial or lateral, with manipulation 24586 Open treatment of periarticular fracture and/or

dislocation of the elbow (fracture distal humerus and proximal ulna and/or proximal radius);

24587 with implant arthroplasty

24600 Treatment of closed elbow dislocation; without anesthesia

24605 requiring anesthesia

24615 Open treatment of acute or chronic elbow dislocation 24620 Closed treatment of Monteggia type of fracture

dislocation at elbow (fracture proximal end of ulna with dislocation of radial head), with manipulation

24635 Open treatment of Monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of radial head), includes internal fixation, when performed

24640 Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation

24650 Closed treatment of radial head or neck fracture; without manipulation

24655 with manipulation

24665 Open treatment of radial head or neck fracture, includes internal fixation or radial head excision, when performed;

24666 with radial head prosthetic replacement 24670 Closed treatment of ulnar fracture, proximal end (eg,

olecranon or coronoid process[es]); without manipulation 24675 with manipulation

24685 Open treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process[es]), includes internal fixation, when performed

Arthrodesis

Coding Atlas

In elbow joint arthrodesis, the joint is surgically fused and immobilized. Bone grafts may be placed to fix the joint; otherwise, hardware is placed.

24800 Arthrodesis, elbow joint; local

24802 with autogenous graft (includes obtaining graft)

Amputation

Coding Atlas

A guillotine amputation creates a flat wound across the limb. It does not provide skin for adequate closure.

Guillotine amputation is typically performed in emergent situations and is followed by wound monitoring for disease prior to a second surgery for revision and flap.

24900 Amputation, arm through humerus; with primary closure 24920 open, circular (guillotine)

24925 secondary closure or scar revision 24930 re-amputation

24931 with implant

24935 Stump elongation, upper extremity

24940 Cineplasty, upper extremity, complete procedure

Forearm and Wrist

Incision

Coding Atlas

Decompression fasciotomy treats compartment

FIGURE 2-28. Muscles of the Forearm and Wrist

The forearm contains many muscles. Muscles in the forearm act as extensors and flexors of the wrist and fingers as well as pronators and supinators that turn the hand palm-up or palm-down. The brachioradialis muscle is a flexor of the elbow. The forearm is divided into two fascial compartments.

The posterior compartment contains the extensors of the hands, and the anterior compartment contains the flexors.

Lateral epicondyle

Common extensor tendon Extensor digitorum and extensor digiti minimi (cut away)

Interosseous membrane Radius Ulna Extensor carpi

radialis longus Extensor carpi radialis brevis Extensor carpi ulnaris

Extensor indicis Abductor pollicis longus Extensor pollicis brevis Extensor pollicis longus Extensor digitorum and extensor digiti minimi tendons (cut)

Right forearm: Posterior (dorsal) view Posterior view

Anconeus muscle Flexor carpi ulnaris muscle Extensor carpi ulnaris muscle

Triceps brachii tendon Brachioradialis muscle Extensor carpi radialis longus muscle

Common extensor tendon Extensor carpi

radialis brevis muscle Extensor digitorum muscle Extensor digiti minimi muscle Abductor pollicis longus muscle

Extensor pollicis brevis muscle Extensor pollicis longus tendon Extensor carpi radialis brevis tendon Extensor carpi radialis longus tendon Abductor pollicis longus tendon Extensor pollicis brevis tendon Extensor pollicis longus tendon 21

43 65 Extensor carpi ulnaris tendon Extensor digiti minimi tendon Extensor digitorum tendons Extensor indicis tendon 5th metacarpal bone Dorsal branch of ulnar nerve

Extensor retinaculum (compartments numbered)

Lateral epicondyle

Common extensor tendon Extensor digitorum and extensor digiti minimi (cut away)

Interosseous membrane Radius Ulna Extensor carpi

radialis longus Extensor carpi radialis brevis Extensor carpi ulnaris

Extensor indicis Abductor pollicis longus Extensor pollicis brevis Extensor pollicis longus Extensor digitorum and extensor digiti minimi tendons (cut)

Right forearm: Posterior (dorsal) view Posterior view

Anconeus muscle Flexor carpi ulnaris muscle Extensor carpi ulnaris muscle

Triceps brachii tendon Brachioradialis muscle Extensor carpi

radialis longus muscle Common extensor tendon Extensor carpi

radialis brevis muscle Extensor digitorum muscle Extensor digiti minimi muscle Abductor pollicis longus muscle

43 65 Extensor carpi ulnaris tendon Extensor digiti minimi tendon Extensor digitorum tendons Extensor indicis tendon 5th metacarpal bone Dorsal branch of ulnar nerve

Extensor retinaculum (compartments numbered)

70 Moderate sedation ✚Add-on code ^Modifier 51 exempt #Resequenced code

Musculoskeletal System

Netter’s Atlas of Surgical Anatomy for CPT Coding

25028 Incision and drainage, forearm and/or wrist; deep abscess or hematoma

25031 bursa

25035 Incision, deep, bone cortex, forearm and/or wrist (eg, osteomyelitis or bone abscess)

25040 Arthrotomy, radiocarpal or midcarpal joint, with exploration, drainage, or removal of foreign body

Excision

Coding Atlas

Size and tumor origin play a role in code selection for excision of soft tissue tumors. The entire resection is measured, not the diameter of the lesion itself, to determine the excision size. Excision of a tumor

originating in the integument, eg, melanoma, is reported with Integumentary System excision codes.

25065 Biopsy, soft tissue of forearm and/or wrist; superficial 25066 deep (subfascial or intramuscular)

25071 Code is out of numerical sequence. See 25065-25240 25073 Code is out of numerical sequence. See 25065-25240 25075 Excision, tumor, soft tissue of forearm and/or wrist area,

subcutaneous; less than 3 cm # 25071 3 cm or greater

25076 Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (eg, intramuscular); less than 3 cm

# 25073 3 cm or greater

25077 Radical resection of tumor (eg, sarcoma), soft tissue of forearm and/or wrist area; less than 3 cm

25078 3 cm or greater

25085 Capsulotomy, wrist (eg, contracture) 25100 Arthrotomy, wrist joint; with biopsy

25101 with joint exploration, with or without biopsy, with or without removal of loose or foreign body

25105 with synovectomy

25107 Arthrotomy, distal radioulnar joint including repair of triangular cartilage, complex

25109 Excision of tendon, forearm and/or wrist, flexor or extensor, each

25110 Excision, lesion of tendon sheath, forearm and/or wrist 25111 Excision of ganglion, wrist (dorsal or volar); primary

25112 recurrent

25115 Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, Tbc, or other granulomas, rheumatoid arthritis); flexors

25116 extensors, with or without transposition of dorsal retinaculum

25118 Synovectomy, extensor tendon sheath, wrist, single compartment;

25119 with resection of distal ulna

25120 Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process);

25125 with autograft (includes obtaining graft) 25126 with allograft

25130 Excision or curettage of bone cyst or benign tumor of carpal bones;

25135 with autograft (includes obtaining graft) 25136 with allograft

25145 Sequestrectomy (eg, for osteomyelitis or bone abscess), forearm and/or wrist

25150 Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); ulna

25151 radius

25170 Radical resection of tumor, radius or ulna 25210 Carpectomy; 1 bone

25215 all bones of proximal row

25230 Radial styloidectomy (separate procedure)

25240 Excision distal ulna partial or complete (eg, Darrach type or matched resection)

Netter’s Atlas of Surgical Anatomy for CPT Coding

Musculoskeletal System

25028—25240

Introduction or Removal

Coding Atlas

A foreign body is an object that has become lodged in the body by accident. A prosthesis is an object that has been placed in the body to assume the role of a natural body part, eg, a joint or bone.

25246 Injection procedure for wrist arthrography

25248 Exploration with removal of deep foreign body, forearm or wrist

25250 Removal of wrist prosthesis; (separate procedure) 25251 complicated, including total wrist

25259 Manipulation, wrist, under anesthesia

Repair, Revision, and/or Reconstruction

Coding Atlas

Dalam dokumen Netter's Atlas of Surgical Anatomy for CPT® Coding (Halaman 92-95)