Results 1 to 5 of 5

Scaphoid Excision, Radial Styloidectomy, & 4-corner fustion

  1. #1
    Dane County - WI
    Default Scaphoid Excision, Radial Styloidectomy, & 4-corner fustion
    Exam Training Packages
    Hi, I am hoping that someone can help me with this surgery. CCI states that I can use a -59 modifier with the scaphoid excision( 25210) but otherwise is bundled into 25800. Since it is the same incison, would you bill it?
    Thanks in advance for any help recieved. DX help would be appreciated also - only found wrist deformity ( 736.00)


    PREOPERATIVE DIAGNOSIS: Right SLAC wrist deformity with lunocapitate DJD.

    POSTOPERATIVE DIAGNOSIS: Right SLAC wrist deformity with lunocapitate DJD.

    NAME OF PROCEDURE: Right scaphoid excision, radial styloidectomy(25230) and 4-corner fusion(25800)

    INDICATION: Patient has had a history of problems with his wrist. He has an obvious old scapholunate ligament injury with a SLAC wrist deformity and also degenerative changes at the lunocapitate joint. The decision has been made to proceed with a scaphoid excision and 4-corner fusion.

    TECHNICAL PROCEDURE: Patient was brought to the operating room and placed supine on the operating room table. After adequate anesthesia was administered with general anesthetic, the right upper extremity was prepped and draped in a sterile fashion. A dorsal approach was made to the wrist. Dissection continued own through the subcutaneous tissue through the extensor retinaculum which was really just a bunch of scar tissue from a prior procedure. The dissection continued into the floor of the 4th dorsal compartment where a dorsal capsulotomy was performed. A subperiosteal/subcapsular dissection was carried out. The scaphoid was identified and separated from its surrounding tissues and removed. A radial styloidectomy was done with an osteotome. Attention was then paid to the 4-corner fusion. A micro-oscillating saw was used to osteotomize the articular surfaces of the carpal bones involved. Guide wires for the Acutrak screw set were then placed across the 4 corners of the fusion and appropriate length Acutrak screws were placed. Good compression was obtained in all fusion sites and fixation was in good position in AP and lateral planes. The wound was then irrigated. Subcutaneous tissues were closed with 2-0 chromic. The skin was closed with 2-0 nylon. A standard volar and dorsal splint was applied.

  2. Default
    I would code 25800 only.

  3. #3
    Dane County - WI
    Thank you for answering - so you would not bill the styloidectomy with code 25800 - is it because it is in the same incision?

  4. #4
    Columbia, MO
    I agree the 25800 only, also dx code I would use the 736.09 for other rather than unspecified and I would code the DJD dx.

  5. #5
    Dane County - WI
    Thumbs up
    Thank you both for answering - I appreciate the help that this forum gives to us - I read them every day to learn something new.

    Thanks again.

Similar Threads

  1. Radial Digital Nerve Excision
    By Nancy Alexander in forum Orthopaedics
    Replies: 0
    Last Post: 06-27-2014, 06:40 AM
  2. Excision of radial head
    By ojonse in forum Orthopaedics
    Replies: 0
    Last Post: 09-25-2013, 11:50 AM
  3. Excision scaphoid bone cysts (3 total)
    By lkmckenzie in forum Outpatient Facilities
    Replies: 2
    Last Post: 03-09-2009, 10:53 AM
  4. Please help w/scaphoid excision
    By Justarose in forum Outpatient Facilities
    Replies: 1
    Last Post: 03-03-2009, 07:29 AM
  5. Carpectomy And Radial Styloidectomy
    By mandywynn in forum Orthopaedics
    Replies: 3
    Last Post: 05-21-2008, 07:55 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.

Get OurFREE2017SalarySurvey.

We'll email you a link to our 2017 Healthcare Salary Survey when it is available so you can see your earning potential.