Wiki EPB Tenodesis

[adunlap23]

The surgeon performed CMC suture suspension arthroplasty. In addition to the primary procedure, he performed EPB tenodesis to the first metacarpal base due to MCP hyperextension.

Is the EPB tenodesis inclusive to CMC arthroplasty even though he is treating hyperextension at a different joint? Or is there a more concise code for this procedure?

 

[NRaizman]

EPB Tenodesis is a separately reportable procedure (25301) and would not be bundled into 25448.
This is supported by both the clinical vignette and the GSD.
The only thing included in 25448 was the tendon work of stabilizing the CMC joint itself, which previously had been coded with 25310 or 26480.
N

 

[adunlap23]

EPB Tenodesis is a separately reportable procedure (25301) and would not be bundled into 25448.
This is supported by both the clinical vignette and the GSD.
The only thing included in 25448 was the tendon work of stabilizing the CMC joint itself, which previously had been coded with 25310 or 26480.
N

Thank you so much!

 

[anagel123]

25448 my surgeons are stating synovectomy of extensor tendons at the wrist at the time of performing CMC arthroplasty/25448, as well as tenolysis of the EPB at the wrist. (CPTs 25118 and 26445 respectively). Are these reimbursable, or considered part of the new/updated code 25448 for the CMC arthroplasty with transposition of FCR?

 

[NRaizman]

Highly unlikely that this is appropriate or reimbursable. Send an op note.

While tenolysis is not inclusive to 25448, there is no reason to routinely perform a tenolysis except to fraudulently inflate billing. The EPB tendon is almost always mobilized during the surgery and so any procedures related to it, other than tenodesis as mentioned above in the setting of MP instability, would generally get bundled.