Orthopedic Coding Alert

Question: Our surgeon performed a proximal row carpectomy (PRC) and circled code 25215. That code refers to all the bones in the proximal row, though, and he only dictated working on four bones. Arent there five bones in the proximal row?

Pennsylvania Subscriber

Answer: Your physician circled the correct code if he addressed the scaphoid, lunate, triquetrum, and pisiform bones. These four bones make up the proximal row of the patients hand.

If the physician documented carpectomies of these bones, you should report 25215 (Carpectomy; all bones of proximal row). If he did not refer to all four of these, you may want to consider reporting 25210 (... one bone) instead. You can report additional units of 25210 if he documented carpectomies of more than one bone.

Note: The surgeon may remove just part of the scaphoid rather than the entire bone, but this should not change your code choice.