Wiki Wrist amputation at proximal carpal row

[adunlap23]

The physician performed:
1. Left wrist amputation at level of the carpal bones
2. Left thumb amputation at MP joint

In his note, he indicates that the trapezium, trapezoid and proximal carpal row were left intact so that the patient would have some function of the wrist for later prosthetic placement. He also performed amputation of the thumb at the MP joint, and left the thumb metacarpal intact (also for prosthetic function).

25920 is for disarticulation at the wrist, but I think this includes removal of all the carpal bones? In this procedure, he only removed the hamate and capitate.

I was thinking: 25920-52, 26951

Thoughts?

 

[NRaizman]

This is 100% not a -52 modifier case.
You can disarticulate the wrist anywhere, whether it be at the CMC level, the mid-carpal level, or radiocarpal level. In each case it would be coded 25920.
Removal of specific carpal bones is not relevant and certainly not a sine qua non. In most cases of amputation, the level is distinguished by the level of the trauma or tumor that is leading to the amputation - you take what you're given and you preserve everything you can.

 

[adunlap23]

This is 100% not a -52 modifier case.
You can disarticulate the wrist anywhere, whether it be at the CMC level, the mid-carpal level, or radiocarpal level. In each case it would be coded 25920.
Removal of specific carpal bones is not relevant and certainly not a sine qua non. In most cases of amputation, the level is distinguished by the level of the trauma or tumor that is leading to the amputation - you take what you're given and you preserve everything you can.

Awesome. Thank you for your reply!