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DRUJ Arthroplasty

Camille Posted Wed 29th of January, 2020 18:25:08 PM
Procedure: Right wrist distal radial ulnar joint arthroplasty and tenolysis of the ECU tendon. Description: "Hockey stick incision made over ECU tendon, just radial and curving over wrist...once the dorsal fascia was identified here, a retinacular flap was fashioned...ECU tendon was found to be densely adherent with scar tissue along it's length...thus ECU tenolysis was performed...soft tissue elevated of the radias and the distal 2 cm was resected with sagittal saw...the template had a good fit which matched what we found intraoperatively...once placed bicortical with compression followed by drilling for the radial peg... trial implant was removed, wound thoroughly irrigated ...and then a size 20 radial plate was seated...Once seated, attention turned to the ulna...the trial stem and ball were seated and 1 cm was marked on the ulnar and the 1cm resection was made..." Op Note goes on to describe the permanent placement of a size 5 ulnar stem..."The cap was placed with the radial pin and this completed the construct." QUESTION #1: the tenolysis should not be unbundled (should not be coded), correct? QUESTION #2: Are both 25441 and 25442 or is 25446 alone the correct coding here? No part of the carpus was resected per the Op Note. THANK YOU!
SuperCoder Answered Thu 30th of January, 2020 05:52:57 AM

Hi Camille,


Thanks for your question. Please find the answer below:


  1. Yes, tenolysis should not be coded with wrist arthroplasty.
  2. Code 25446 (total wrist arthroplasty) alone is correct to report because it includes both components i.e. radial and ulnar.


Please feel free to write if you have any question.



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