Summary & Overview
CPT 25332: Excision of Distal Radius and Carpal Bone with Stabilization
CPT code 25332 represents excision of diseased cartilage and bone of the distal radius and carpal bones, with possible internal fixation or soft-tissue stabilization. This surgical code captures procedures aimed at relieving pain, removing arthritic or necrotic joint elements, and restoring wrist stability through implants or tissue-based stabilization. The code is relevant nationally as it drives coverage determinations, surgical billing, and resource allocation for complex wrist reconstructions and salvage procedures.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for when the code is used, typical sites of service, and the service type classification. The publication also summarizes common billing modifiers provided in the input, outlines payer coverage considerations, and highlights benchmark and policy topics that affect reimbursement and clinical coding practices. The material is intended for billing professionals, surgical providers, and policy analysts seeking a compact reference to the clinical intent and billing context of CPT code 25332 without state-specific variation. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 25332 describes a surgical procedure in which the provider excises diseased cartilage and bone from the distal radius and carpal bones of the wrist. The procedure may include affixing a metal implant or fixation devices to provide stability to the joint, or repositioning the radius and carpal bones and stabilizing them using nearby soft tissues.
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Service type: Surgical debridement and partial wrist joint excision with internal fixation or soft-tissue stabilization
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Typical site of service: Operating room or ambulatory surgical center for inpatient or same-day surgical management of wrist joint disease
Clinical & Coding Specifications
Clinical Context
A 58-year-old right-hand dominant patient with progressive post-traumatic arthritis of the wrist presents with chronic dorsal wrist pain, limited range of motion, and crepitus after prior distal radius fracture and degenerative changes. Conservative management including splinting, NSAIDs, activity modification, corticosteroid injections, and occupational therapy has failed to provide durable relief. Imaging (radiographs and CT) demonstrates collapsed articular surfaces of the distal radius and carpal bones with joint-space narrowing and osteophyte formation.
The orthopedic hand surgeon discusses surgical options and proceeds with a partial wrist arthrodesis and excision of diseased cartilage and bone of the distal radius and carpal bones. Intraoperatively, the surgeon debrides the arthritic surfaces, may reposition the radius and carpus, and applies internal fixation (plates, screws, or circular fixation) or bone graft as needed to stabilize the reconstruction. Typical perioperative workflow includes preoperative evaluation, informed consent, regional or general anesthesia, intraoperative fluoroscopy, sterile implant tray availability, postoperative immobilization (sling and cast or splint), and coordinated hand therapy for rehabilitation. Expected site of service is an outpatient ambulatory surgery center or hospital operating room depending on comorbidities and anesthesia plan.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side |