Wiki Forearm flexor tendon tenolysis

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lchiriac

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Hello everyone, when it comes to forearm flexor tendon tenolysis, are you counting the tendons or the digits? Any article or documentation to back up will be very helpful. Thank you.
 
25295 is defined in the CPT Book as "each tendon", not each digit. The FDS and FDP are completely separate structures and are both anatomically distinct and performative of different functions in the finger. There is no reason to consider any other interpretation, and there is no CPT-A or CMS guidance that would contravene.
Is there a reason you would go directly against the definition of the code and redefine as per digit and not per tendon, or is this a response to a denial?
N.
 
Thank you for your quick reply. When it comes to the forearm flexor tendons, will FDS and FDP be considered 2 tendons or 8? Please see below op report documentation as we are trying to confirm if 25295 should be billed x2 or x8.
"Prior laceration and incision was re incised and extended proximally. There was abundant scar tissue which was carefully released proximally. The ulnar nerve and artery were identified and traced distally until they were able to be safely protected. This was performed likewise for the median nerve and then careful dissection of abundant scar tissue was performed at the level of the distal forearm where the transverse laceration was meeting the longitudinal incisions. The scar dissection was tedious and required lengthy amount time in order to prevent inadvertent injury. The flexor tendons were able to be tenolysed including all 4 flexor digitorum superficialis and additionally the carpal tendon was re-incised and distal dissection was performed until there was full excursion of all flexor tendons. The flexor digitorum profundus was likewise dissected circumferentially until there was full tendon gliding. The flexor pollicis longus was then able to be identified and appeared to have ruptured and was found distally within the flexor pollicis longus tunnel in between the thenar muscles. This was retracted freshened and appeared where the FPL muscle belly was found proximally and retracted and dissected this using modified banal in a 5-0 Prolene epitendinous suture was performed. The median nerve was tenolysed with surrounding scar tissue until healthy vessels were visualized and this was likewise performed for the ulnar artery. The ulnar artery was inspected and the arterial anastomosis was intact and milking of the artery revealed flow through of the arterial anastomosis. The wound was copiously irrigated with sterile saline. The ulnar nerve and median nerve appeared to be well healed and there is no neuroma formation. The subcutaneous tissue was repaired with 3-0 Vicryl and skin was repaired with a combination of 4-0 Monocryl and 4-0 nylon for the carpal tunnel incision?"
 
EACH superficialis and EACH profundus is a separate tendon.
This is reflected clearly in the MUE for 25295 which is 9, reflecting the four FDS, the four FDP and the FPL.
(it should be 11, to reflect the FCR and FCU, but that is a minor gripe)
 
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