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Tag Archives: Arthrotomy

Wrist arthrotomy

Posted on by
My provider did an open wrist joint exploration which leads me to codes 25040 & 25101. All he did was exploration. What would lead me to chose one code over the other?

Can anyone explain the difference between codes 25040 & 25101? I understand 25101 is for joint exploration; with/without biopsy, with/without removal foreign body. However the only difference I see between these codes is the word ‘drainage’ in code 25040.

In code 25040 do you need to perform exploration AND either drainage or foreign body removal or is any one of the 3 (exploration OR drainage OR foreign body removal).

I appreciate any and all feedback.

Thank you!!

Medical Billing and Coding Forum

Arthrocentesis vs Arthrotomy

Posted on by
Hello

My provider performed a right ankle arthrocentesis (20605) and right ankle arthrotomy (27620) during the same operation. CPT 27620 was the only code billed as there is a CCI edit between 27620 and 20605. The provider is saying that the arthrocentesis was performed in order to decide whether or not to perform the arthrotomy. He feels that 20605 should be coded and billed with a modifier 59.

Does the above scenario qualify as a ‘Distinct Procedural Service’ and does it justify appending modifier 59 to 20605?
Or would this be a diagnostic/surgical scenario? For instance, we wouldn’t code a diagnostic laparoscopy if performed in conjunction with a surgical laparoscopy..

Thanks in advance.

Medical Billing and Coding Forum

Incision & drainage vs arthrotomy

Posted on by
My doctor made 6CM incision over the dorsal wrist dissected down open retinaculum to expose EDC & EPL tendons.He opened the wrist capsule and noted immediate release of purulent drainage sent to pathology. He then irrigated wound, split the capsule,irrigated the wrist cauterized bleeders and placed a Penrose drain in the radiocarpal joint. Would 25040 or 25101 be more appropriate than 25028? Any help would be appreciated.

Medical Billing and Coding Forum

Arthrotomy (olecranon) and excision of olecranon bursa

Posted on by
I am struggling with the fact that the codes bundle for these procedures and what seems to be the lesser procedure (24105) is the primary code and the arthrotomy is code 2 of the pair (24101/24000).
PROCEDURE: Incision and drainage of chronic draining olecranon bursa from left elbow (Charcot joint) with arthrotomy of pseudojoint, Charcot joint, left elbow and excision of chronically inflamed/infected olecranon bursa, left elbow.
Physician incises and identifies chronically inflamed bursa, opens bursa, collects fluid, sends for culture, etc., physician then carefully dissects the bursa down to origin of pseudojoint and opens joint capsule. Pseudojoint is thoroughly irrigated with 3L normal saline using cystoscopy tubing including removal of several large foreign bodies. At end of procedure surgeon excised majority of the olecranon bursa and sent for pathologic exam. A small bit was left attached to the pseudojoint capsule. Closure ensued…..
Any guidance in the proper coding of this is very much appreciated! Thanks in advance….

Medical Billing and Coding Forum