Summary & Overview
CPT 25295: Tendon Adhesion Release, Forearm or Wrist
CPT code 25295 designates a surgical tendon adhesion release in the forearm or wrist performed to free a tendon from scar tissue or adhesions and restore normal movement. Nationally, this procedure addresses post-injury or post-surgical stiffness and functional limitation in the upper extremity and is relevant to hand surgeons, orthopedic surgeons, and rehabilitation teams managing tendon dysfunction. Key payers commonly involved in coverage decisions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical framing of the procedure, common settings where the service is delivered, and an outline of payer coverage considerations and typical billing modifiers. The publication provides benchmarking context where available, summarizes policy and coding considerations that affect claim adjudication, and highlights clinical circumstances that commonly justify the procedure. Data not available in the input is clearly identified where applicable.
Billing Code Overview
CPT code 25295 describes a surgical procedure in which the provider frees a tendon in the forearm or wrist from adhesions or scar tissue resulting from a prior surgery or injury to restore normal movement. This procedure is focused on releasing tendon adhesions to improve tendon gliding and joint function.
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Service type: Surgical tendon adhesion release
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Typical site of service: Operating room, ambulatory surgery center, or hospital outpatient setting
Clinical & Coding Specifications
Clinical Context
A 45-year-old right-hand dominant patient presents with limited wrist and finger tendon excursion months after a distal radius fracture and surgical fixation. Conservative management including physical therapy and splinting failed to restore active range of motion. Examination demonstrates painful, restricted flexion and extension of the wrist and digits consistent with peritendinous adhesions. Preoperative imaging and clinical exam localize adhesions to the flexor tendons in the volar wrist and distal forearm. The surgical plan is operative exploration with release of tendon adhesions to restore gliding and improve range of motion under regional or general anesthesia. Typical workflow includes preoperative evaluation and informed consent, operative time in an ambulatory surgery center or hospital outpatient department, intraoperative identification and careful lysis of adhesions (occasionally with tenolysis of individual tendons), hemostasis, wound closure, and immediate postoperative splinting followed by early hand therapy to maintain gains in motion.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, or intensity substantially exceeds typical for 25295 and documentation supports additional work. |