Wiki Excision of calcinosis cutis mass from wrist joint

[Rufus186]

I am having trouble finding a code for the excison of a calcinosis cutis mass in the wrist joint. This was not a ganglion to support 25111 but was excised in the joint so 25076 doesnt necessarily fit the procedure.

Open carpal tunnel release was done as well

Path lab result calcinosis cutis

Op note reads as follows, ...the mass (2cm) was firmly adherent to the capsule of the wrist join tand then using sharp dissection gently on the ulnar aspect the mass was slowly elevated. There was a stalk that was going right down to the joint. When this was transected white chalky material similiar to gout was extruded from the mass. This was completely shelled out. There did not appear to be any invasion of the tendons. The FPL that had been displaced was intact as well as the digital flexors.
Looking at the wound, the bones were palpable of the wrist; however, they were not readily seen. It did appear this was a ventral rent in the capsule. The portion of the capsule that was overlying what appears to be the white chalky material was transected and also sent to pathology. There was enough of this left and this was repaired the volar rent of the capsule with 3-0 Ethibond in a figure of eight suture configuration.

Thanks in advance

 

[fish4codes]

What about 25130 (it doesn't bundle with your 64721).

The CPT Lay Description reads: 25130-25136 (25130, 25135, 25136)

A bone cyst or benign tumor of the carpal bones is removed. The physician makes an incision in the wrist overlying the cyst or tumor. The skin and underlying soft tissues are reflected to expose the periosteum, which is separated from the bone. Curettes or osteotomes are used to scrape or cut the lesion from the bone. Once the benign tumor or cyst is removed and healthy bone tissue is present, the periosteum is repositioned and the incision is repaired in layers. If the bone defect created requires a graft for repair, the physician obtains the necessary size bone graft from a separate donor site on the patient and packs it into the site where the tumor or bone cyst was removed or uses a bone bank allograft. Report 25135 if the procedure is done with an autograft and 25136 if an allograft is used.

I'll be curious to see what others think!