Summary & Overview
CPT 25248: Removal of Deep Foreign Body, Forearm or Wrist
CPT code 25248 represents surgical removal of a deeply embedded foreign body from the forearm or wrist, a procedure often performed after traumatic injuries. Nationally, this code matters because it captures a distinct, operative service that can involve variable resource use — from simple extraction in an outpatient surgical center to complex exploration in a hospital setting — and it informs payment, quality reporting, and trauma care workflows.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for the procedure, typical sites of service, common billing modifiers associated with surgical procedures, and the payer mix addressed. The publication summarizes benchmark payment and utilization patterns where available, highlights relevant coding considerations for accurate claim submission, and outlines implications for hospital and ambulatory surgical center reporting.
This summary equips coding managers, billing professionals, and clinical leaders with the context needed to classify and document deep forearm/wrist foreign body removals accurately and to understand how such services are represented across major national payers.
Billing Code Overview
CPT code 25248 describes the removal of a foreign body deeply embedded in the forearm or wrist, typically arising from traumatic injury. This procedure involves surgical exploration and extraction of material lodged beneath skin and soft tissues of the distal forearm and wrist.
-
Service type: Surgical procedure for deep foreign body removal
-
Typical site of service: Hospital operating room or ambulatory surgical center, and may also occur in an emergency department when indicated
Clinical & Coding Specifications
Clinical Context
A 28-year-old male presents to the emergency department after falling on broken glass while cutting cardboard. He reports increasing pain, swelling, and inability to move his wrist extension. Physical exam identifies a deeply embedded fragment palpable in the volar forearm proximal to the wrist with point tenderness, small puncture wound, and limited range of motion. Neurovascular exam is intact but there is concern for tendon irritation. Plain radiographs show a radiopaque foreign body within the soft tissues of the distal forearm. The patient is consented for removal of a deeply embedded foreign body under regional block or local anesthesia with possible sedation.
The clinical workflow includes triage and initial wound care, imaging (plain radiograph and, if needed, ultrasound or CT for non-radiopaque fragments), informed consent, pre-procedure checklist, anesthesia (local or brachial plexus block), surgical exploration of the wound, meticulous dissection to locate and remove the foreign body, irrigation and debridement as indicated, wound closure or delayed closure per contamination, tetanus update if needed, post-procedure neurovascular reassessment, and documentation of the removed object, procedure performed, anesthesia, and findings. Typical setting is an emergency department or ambulatory surgical center; outpatient operating room may be used for complex removals.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Data not available in the input. | Data not available in the input. |
26 | Professional component | Use when reporting only the physician's professional work separate from technical component (rare for foreign body removal unless imaging interpretation is separately billed). |
50 | Bilateral procedure | Use when identical procedures are performed on both forearms/wrists during the same operative session. |
52 | Reduced services | Use when the procedure is partially reduced or not completed as planned. |
53 | Discontinued procedure | Use when the procedure is terminated due to extenuating circumstances before completion. |
54 | Surgical care only | Use when another provider bills for postoperative care and the surgeon bills only the intraoperative service. |
55 | Postoperative management only | Use when another provider performed the surgery and the reporting provider only manages postoperative care. |
62 | Two surgeons | Use when two surgeons work together as primary surgeons for complex removal. |
66 | Surgical team | Use when a surgical team approach is required for complex cases. |
76 | Data not available in the input. | Data not available in the input. |
RT | Right side | Use to identify the procedure performed on the right forearm/wrist. |
LT | Left side | Use to identify the procedure performed on the left forearm/wrist. |
59 | Data not available in the input. | Data not available in the input. |
GT | Data not available in the input. | Data not available in the input. |
22 | Increased procedural services | Use when work required to remove the foreign body is substantially greater than typical and documentation supports unusual effort or complexity. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207P00000X | Orthopaedic Surgery | Orthopaedic surgeons commonly remove deep foreign bodies in the forearm/wrist, especially when tendons, bones, or complex anatomy are involved. |
| 207L00000X | Hand Surgery | Hand surgeons specialize in delicate forearm and wrist procedures with emphasis on tendon, nerve, and vascular preservation. |
| 2080P0002X | General Surgery | General surgeons may remove foreign bodies in acute trauma settings, particularly in the emergency department or trauma center. |
| 207K00000X | Emergency Medicine | Emergency physicians frequently perform foreign body removals in the ED, often for superficial and some deep embedded objects under local/regional anesthesia. |
| 207R00000X | Plastic Surgery | Plastic surgeons perform complex soft tissue exploration and reconstruction when significant contamination or tissue loss is present. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
S61.01XA | Puncture wound without foreign body of right forearm, initial encounter | Common presenting diagnosis when a penetrating injury introduces a foreign body into the forearm requiring removal. |
S61.02XA | Puncture wound without foreign body of left forearm, initial encounter | As above for the left side. |
T14.8 | Other injury of unspecified body region | Used when the specific anatomic diagnosis is not fully specified but a foreign body removal is necessary. |
S62.90XA | Unspecified fracture of wrist and hand, initial encounter | Included when a foreign body injury is associated with an occult or associated fracture requiring concurrent management. |
L72.0 | Data not available in the input. | Data not available in the input. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
10120 | Removal of foreign body, subcutaneous tissues; simple (e.g., needle, splinter) | Performed for superficial foreign bodies; may be billed instead of 25248 when the object is not deeply embedded. |
20526 | Injection, therapeutic, of tendon sheath, single or multiple; forearm/wrist | May be performed later for tenosynovitis if tendon irritation persists after removal. |
20610 | Aspiration and/or injection of a major joint or bursa; therapeutic (e.g., wrist joint) | May be used for diagnostic or therapeutic aspiration if joint involvement or septic arthritis is suspected in conjunction with foreign body injury. |
26010 | Incision and drainage, deep abscess, forearm; and/or exploration | Performed when infected foreign bodies require more extensive incision, drainage, and exploration beyond simple removal. |
20550 | Injection, therapeutic, tendon sheath; small joint | May accompany management of secondary soft tissue issues after removal. |
64415 | Nerve block, upper extremity; brachial plexus, single injection | Used for regional anesthesia to facilitate removal of a deeply embedded foreign body in the forearm/wrist. |