# Carpal Boss Excision



## coderguy1939

I'd like to know what procedure codes other coders use for excision of a carpal boss located at the carpometacarpal joint.  I can find codes for the carpal or metacarpal bones but not for the carpometacarpal joint.  Thanks.


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## mbort

can you post the sanitized note?


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## coderguy1939

There is no op report.  This is a request for a CPT code for preauthorization for bone excision at the carpometacarpal joint for carpal bossing.


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## mbort

I would go with the 25130 then


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## coderguy1939

Thanks, I appreciate your input.


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## EMS7775

*Carpal bossing dx*

I would like to know what other coders are using for carpal bossing dx?


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## sdomel159

I agree with 25130


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## martnel

emr7775 said:


> I would like to know what other coders are using for carpal bossing dx?



I use 726.91, with the 25130 CPT, as others has said.


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## Jamie Dezenzo

Per Orthro coding alert (Jan. 2006)

READER QUESTIONS: Look to 26230 for Carpal Bossing

Question: Which CPT and ICD-9 codes should I report when the surgeon documents carpal bossing?


Texas Subscriber


Answer: Because a carpometacarpal boss occurs at the base of the second and third metacarpals, it constitutes a “partial” excision. Therefore, you should report 26230 (Partial excision [craterization, saucerization, or diaphysectomy] bone [e.g., osteomyelitis]; metacarpal) when the surgeon documents carpal bossing. 

For the diagnosis code, the American Society for Surgery of the Hand recommends 718.04 (Articular cartilage disorder; hand). 

If your surgeon thinks that 733.99 (Other and unspecified disorders of bone and cartilage; other) is more appropriate for your patient's case, you should select that code instead.


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## EMS7775

Thanks Martn, I appreciate your help.


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## martnel

Jamie, I like your answer!  Will ponder over it a bit more!


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