# 3 part distal radius ORIF WITH tenotomy of brachioradialis



## NEOSM507 (Apr 8, 2019)

Our provider is performing a tenotomy of the brachioradialis tendon (CPT 25290) during an ORIF of a distal radius fracture (CPT 25609) He is using the same fracture diagnosis on both the ORIF and the tenotomy.

Documentation: 
 "_due to the pull of the brachioradialis , it was not possible to reduce the fracture.  Therefore, a brachioradialis tenotomy was performed."_, or

" _brachioradialis tenotomy was performed in a subperiosteal fashion to allow radial styloid manipulation"
_

Although there are no bundling edits on these codes, it is my feeling that this is would be part of the ORIF approach, and not separately reportable.

Am I right in saying this?


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## Orthocoderpgu (Apr 9, 2019)

*I have not had any issues with this tenotomy*

I have not had any issues with billing the tenotomy so far. AAOS does not consider this to be inclusive, so your surgeon probably sees it the same way. 

Some insurance companies may pay for it, others may not. Keep track so you can adjust your coding accordingly.


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## fish4codes (Apr 17, 2019)

Hope this helps...

Source: CPT®Assistant December 2013 Volume 23 Issue 12  
"Question: When performing an open reduction and internal fixation of a three-part or greater distal radius fracture (code 25609) is the release of the brachioradialis considered an integral part of the procedure when it is done to facilitate reduction?

Answer: Yes. Release of the brachioradialis tendon is part of the reduction and work involved in code 25609, Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 3 or more fragments, and is not separately reported"

Source: CPT®Assistant November 2012 Volume 22 Issue 11 
"Question: An open reduction internal fixation of the extra-articular right distal radius fracture was performed (25607). A brachioradialis tendon release was also performed. Is the tendon release included in code 25607?

Answer: Yes. CPT code 25607, Open treatment of distal radial extra-articular fracture or epiphyseal separation, with internal fixation, includes release of the brachioradialis tendon and fracture treatment with internal fixation."


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## katz0813 (Jun 1, 2020)

fish4codes said:


> Hope this helps...
> 
> Source: CPT®Assistant December 2013 Volume 23 Issue 12
> "Question: When performing an open reduction and internal fixation of a three-part or greater distal radius fracture (code 25609) is the release of the brachioradialis considered an integral part of the procedure when it is done to facilitate reduction?
> ...



Do you have a copy of these publications with the related codes? Are you able to copy them so that I may show them to my provider.
Thanks,
Nancy


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