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CPT 25270: Repair of Extensor Tendon or Muscle, Forearm or Wrist
CPT code 25270 represents an acute surgical repair of an extensor tendon or extensor muscle in the forearm or wrist performed shortly after traumatic injury. This code captures time-sensitive, operative management of extensor mechanism injuries that, if untreated, can lead to persistent functional deficits of the wrist and hand. Nationally, proper coding for these repairs affects surgical quality measurement, payment adjudication, and care coordination across inpatient and ambulatory surgical settings.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines typical sites of service (operating room, hospital outpatient department, ambulatory surgery center) and clarifies the clinical context for acute traumatic extensor repairs.
Readers will learn the clinical scope and billing context for CPT code 25270, common payer coverage considerations, and where to find related policy language. The report provides benchmarks for utilization and payment patterns, highlights policy updates that affect surgical billing and prior authorization, and summarizes clinical indications tied to the code. Data elements not provided in the input (such as associated taxonomies, specific ICD-10 pairings, and related codes) are identified as unavailable where applicable.
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Billing Code Overview
CPT code 25270 describes a surgical procedure in which the provider repairs an extensor tendon or muscle of the forearm or wrist following a traumatic injury, performed soon after the injury. This service is a surgical repair of the extensor mechanism in the distal forearm or wrist region.
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Service type: Surgical repair of extensor tendon/muscle (acute traumatic repair)
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Typical site of service: Operating room or procedure suite in an acute care setting, including hospital outpatient departments or ambulatory surgery centers