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Orthopedic Coding Alert

Reader Question:

Synovectomy Encompasses Ganglion Excision In Hand

Published on Fri Dec 14, 2012

Question: In a patient diagnosed with synovitis with first dorsal compartment tendinitis and ganglion formation from extensor carpi ulnaris (ECU), our surgeon did the following procedures: 1. Exploration, volar radial mass, with first dorsal compartment release and excision of tenosynovitis
2. Excision, ganglion formation from ECU and neurolysis of dorsal cutaneous nerve New Jersey Subscriber Answer: You report 25111 (Excision of ganglion, wrist [dorsal or volar]; primary) for the ganglion that your surgeon is excising. You do not separately bill for the synovectomy in this situation. According to the American Academy of Orthopedic Surgeons (AAOS) Complete Global Service Data Guide, synovectomy codes, 25105 (Arthrotomy, wrist joint; with synovectomy), 25115 (Radical excision of bursa, synovia of wrist, or forearm tendon sheaths; flexor), 25116 (Radical excision of bursa, synovia of wrist, or forearm tendon sheaths; extensors) or 25118 (Synovectomy, extensor tendon sheath, wrist, single compartment), are included in the global charge [...]
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