2025 CPT code 25449
(Active) Effective Date: N/A Revision Date: N/A Surgery - Wrist Procedures Musculoskeletal System Feed
Revision of a wrist arthroplasty, including implant removal.
Modifiers may be applicable, such as modifier 58 (staged or related procedure) if the revision is performed during the postoperative period of the initial arthroplasty, modifier 76 (repeat procedure) if the procedure is a repeat of a prior procedure performed by the same physician, or others as clinically indicated.Consult the CPT manual for a complete list of applicable modifiers.
Medical necessity is established by the presence of persistent pain, instability, infection, or failure of the original wrist implant.Documentation should support the need for revision surgery, including imaging findings, and the failure of conservative management options.
The clinical responsibility lies with the surgeon performing the procedure. This includes pre-operative assessment, surgical intervention (including incision, implant removal, debridement if necessary, and potential implant replacement), and post-operative care instructions.
In simple words: The doctor reopens the wrist joint to remove and possibly replace a previously implanted artificial joint. This is often done if the joint is infected or loose.
This procedure involves the revision of a previously performed wrist arthroplasty.It includes the re-opening of the wrist joint, removal of the existing prosthetic implant(s) from the distal radius and/or carpal bones, potential debridement of the joint, and possible insertion of a new prosthesis.The procedure may involve removal of the prosthesis from the radius and one or more metacarpals. Post-operative splinting is typically included.
Example 1: A patient with a previous total wrist arthroplasty presents with persistent pain and radiographic evidence of loosening of the prosthesis.A revision arthroplasty is performed to remove the loose implant and replace it with a new one., A patient experiences a wrist infection following a total wrist arthroplasty.The surgeon performs a revision arthroplasty to remove the infected implant, debride the infected tissue, and insert a new prosthesis after the infection has been successfully treated., A patient with a previous total wrist arthroplasty experiences implant failure due to wear and tear. A revision arthroplasty is performed to replace the failed implant with a new one.
Preoperative imaging (X-rays), operative report detailing the procedure performed (including implant removal and replacement, if applicable), intraoperative and postoperative photographs (if available), pathology report if tissue is sent for analysis, and post-operative instructions.
** The complexity of the revision procedure may influence the coding and billing process. The extent of bone resection, soft tissue manipulation, and the type of implant used should be carefully documented. Always refer to the most recent CPT coding guidelines for accurate coding.
- Revenue Code: P3D (Major Procedure, Orthopedic - Other)
- RVU: This information is not available in the provided source.Refer to the CMS national physician fee schedule for the most current RVU data.
- Global Days : The global period for this procedure is not specified in the provided data.The appropriate global period should be determined based on local or payer guidelines.
- Payment Status: Active
- Modifier TC rule: The application of a technical component (TC) modifier may be required based on the specifics of the case and payer guidelines.Careful consideration of the nature of the service is necessary.
- Fee Schedule : This information is not available in the provided source. Consult payer fee schedules and historical data for information about historical fee.
- Specialties:Orthopedic Surgery, Hand Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center, Office