Overview of CPT Code 25400: Excision of Ganglion Cyst, Wrist
CPT Code 25400 refers to the surgical excision of a ganglion cyst located on the wrist. Ganglion cysts are noncancerous lumps that often develop along the tendons or joints of the wrists and hands, filled with a jelly-like fluid.
When CPT Code 25400 is Used?
This procedure is indicated in several clinical scenarios.
- Persistent pain or discomfort caused by the ganglion cyst.
- Cyst size increasing or causing functional impairment.
- Cyst causing pressure on surrounding nerves.
- Failure of conservative treatments such as aspiration or splinting.
Symptoms Indicating This Procedure
Patients may report various symptoms that lead to the consideration of this procedure.
- A visible lump on the wrist that may fluctuate in size.
- Pain or discomfort in the wrist, especially during movement.
- Numbness or tingling in the fingers if the cyst compresses a nerve.
- Weakness in the wrist or hand.
Causes and Risk Factors
Understanding the causes and risk factors can help in prevention and management.
- Repetitive wrist movements or overuse.
- Previous wrist injuries or trauma.
- Certain occupations that involve repetitive wrist strain.
- Genetic predisposition to developing cysts.
Diagnostic Tests Before Procedure
Several diagnostic tests may be performed to confirm the diagnosis.
- Physical examination to assess the cyst's characteristics.
- Ultrasound imaging to visualize the cyst and surrounding structures.
- MRI may be used in complex cases to evaluate the cyst's relationship with nearby tissues.
Procedure Description
The excision procedure involves several key steps.
- The patient is positioned comfortably, and the wrist is cleaned and sterilized.
- Local anesthesia is administered to numb the area around the cyst.
- An incision is made over the cyst to access it.
- The cyst is carefully excised along with its stalk to minimize the chance of recurrence.
- The incision is closed with sutures, and a sterile dressing is applied.
Preparation for the Procedure
Proper preparation is essential for a successful procedure.
- Avoid blood-thinning medications such as aspirin or ibuprofen for a week prior.
- Inform the surgeon of any allergies or medical conditions.
- Arrange for transportation home post-procedure if sedation is used.
- Follow any specific instructions provided by the healthcare provider.
Recovery and Aftercare
Post-operative care is crucial for healing.
- Rest the wrist and avoid strenuous activities for at least two weeks.
- Keep the incision clean and dry; follow wound care instructions.
- Pain management may include over-the-counter pain relievers.
- Attend follow-up appointments to monitor healing and remove sutures if necessary.
Possible Complications
While complications are rare, they can occur.
- Infection at the incision site.
- Scarring or changes in skin sensation.
- Recurrence of the ganglion cyst.
- Nerve damage leading to persistent pain or numbness.
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Post-Procedure Follow-Up
Follow-up care is important for assessing recovery.
- A follow-up appointment is typically scheduled within 1-2 weeks post-surgery.
- Monitoring for signs of infection or complications.
- Assessment of pain levels and functional recovery.
Alternative Treatments
Non-surgical options may be considered before excision.
- Aspiration of the cyst to relieve pressure and pain.
- Wrist splinting to immobilize the area and reduce symptoms.
- Physical therapy to strengthen the wrist and improve function.
Home Care Tips
Simple home care can aid in recovery.
- Apply ice packs to reduce swelling in the first 48 hours.
- Keep the wrist elevated to minimize swelling.
- Follow a balanced diet to support healing.
- Avoid heavy lifting or strenuous activities until cleared by the doctor.
Patient Education & Prevention
Education can help prevent recurrence.
- Understand the importance of wrist ergonomics in daily activities.
- Engage in wrist-strengthening exercises as recommended.
- Avoid repetitive strain on the wrist when possible.
- Seek early treatment for wrist injuries to prevent complications.
Billing and Coding Information
CPT Code: 25400
Category: Surgery
Common Modifiers:
- 50 - Bilateral procedure
- RT - Right side
- LT - Left side
Average Cost and Insurance Coverage
Costs can vary based on several factors.
- The average cost of the procedure ranges from $1,500 to $3,000.
- Insurance may cover the procedure if deemed medically necessary.
- Out-of-pocket costs depend on the patient's insurance plan and deductible.
Related CPT Codes
Frequently Asked Questions (FAQs)
What is a ganglion cyst?
A ganglion cyst is a noncancerous lump filled with fluid that typically forms on the wrist or hand.
Is the excision procedure painful?
Local anesthesia is used during the procedure, so pain is minimal. Some discomfort may occur post-surgery.
How long does recovery take?
Most patients can return to normal activities within 2-4 weeks, depending on individual healing.
Will the cyst come back after surgery?
While recurrence is possible, complete excision reduces the likelihood significantly.
