2025 CPT code 25145
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Musculoskeletal System Musculoskeletal System Feed
Sequestrectomy (e.g., for osteomyelitis or bone abscess), forearm and/or wrist.
Modifiers may be applicable depending on the circumstances of the procedure (e.g., 51 for multiple procedures, 76 for a repeat procedure).
Medical necessity for sequestrectomy is established by the presence of a sequestrum causing persistent infection, pain, or functional impairment.Conservative management (antibiotics) has failed to resolve the condition.The procedure is medically necessary to facilitate healing and prevent further complications.
The surgeon's responsibilities include pre-operative planning, incision and exposure, meticulous dissection to avoid nerve and vascular injury, removal of the sequestrum and infected tissue, wound debridement (if necessary), wound closure (primary or secondary intention), and post-operative care.
In simple words: This surgery removes a piece of dead bone (a sequestrum) in the forearm or wrist.This is often done to treat a bone infection or abscess. The surgeon makes an incision, removes the dead bone and any infection, and then closes the area.
Sequestrectomy of the forearm and/or wrist involves the surgical removal of a sequestrum, a piece of dead bone, often associated with osteomyelitis (bone infection) or a bone abscess. The procedure includes incision, retraction of blood vessels and nerves, removal of the sequestrum and any surrounding infected tissue, possible debridement using a burr, and closure of the wound with sutures and drainage.The wound may alternatively be left open to heal by secondary intention.
Example 1: A 55-year-old male presents with chronic osteomyelitis of the radius following a forearm fracture.A sequestrectomy is performed to remove the necrotic bone fragment and infected tissue., A 28-year-old female experiences a deep wound infection in her wrist after a laceration.A sequestrum forms, requiring sequestrectomy to facilitate healing., A 72-year-old male with diabetes develops a bone abscess in his forearm.Surgical debridement and sequestrectomy are performed to resolve the infection.
* Thorough history and physical examination documenting the presence of osteomyelitis or bone abscess.* Pre-operative imaging (X-rays, CT scans) to identify the location and extent of the sequestrum.* Intraoperative photographs and operative notes detailing the procedure, including the size and location of the sequestrum removed.* Post-operative imaging (if indicated).* Pathology report confirming the diagnosis.
** The extent of the sequestrectomy and the need for additional procedures (e.g., bone grafting, wound reconstruction) will vary depending on the individual case.
- Revenue Code: P5B (AMBULATORY PROCEDURES - MUSCULOSKELETAL)
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Orthopedic Surgery, Hand Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center