AMA CPT® Assistant - 1997 Issue 4 (April)
Musculoskeletal, 25295 (Q&A) (April 1997)
April 1997 page 11-end Coding Consultation Musculoskeletal, 25295 (Q&A) Question We are trying to bill for tenolysis for six flexors in the wrist. Should we list out all flexors and bill for each flexor, or should we list tenolysis once and place a six in the units column of the HCFA 1500? AMA Comment Because the descriptor refers to each tendon, it would be appropriate to report code 25295 , Tenolysis, flexor or extensor tendon, forearm and/or wrist, single each tendon, once, with a six in the units column. However, it is also appropriate to list each code and...
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Article Overview
This article is a short AMA Coding Consultation Q&A from CPT Assistant focused on musculoskeletal reporting guidance for a procedure involving tendons in the wrist and forearm. It is relevant to coders and billing staff who work with CPT procedure reporting, unit-based claims, and modifier usage in physician and outpatient claims. The discussion centers on general reporting options and payer variation without providing a full case study or broad policy update.
Why This Topic Matters
It helps readers determine whether the article addresses CPT reporting questions, unit billing, and multiple-procedure modifier use for musculoskeletal services. This can be useful when reviewing similar claim-splitting or units-versus-line-item questions.
Article Sections
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April 1997 page 11-end
Introductory publication information for the coding consultation and its placement in the issue.
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Coding Consultation
The main Q&A format presenting a billing/reporting question and the editorial response.
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Question
The reader’s inquiry about how to report a musculoskeletal tendon procedure on a claim.
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AMA Comment
The AMA’s response describing general reporting approaches and noting payer-dependent preferences.
What You Will Learn
- How this Q&A frames a musculoskeletal CPT reporting issue
- That the article discusses claim reporting options for a tendon-related procedure
- That modifier use and units reporting are part of the discussion
- How payer-specific preferences are presented in a general coding consultation format
Who Should Read This
- Medical coders
- Billing staff
- Physician practice administrators
- Compliance staff
- Orthopedic and musculoskeletal coding specialists
Codes Discussed
Modifiers Discussed
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