CPT® Code 25820

Arthrodesis, commonly known as joint fusion, is a surgical procedure aimed at alleviating pain and enhancing joint stability, particularly in the wrist. This procedure is often indicated for patients suffering from various conditions such as rheumatoid arthritis, osteoarthritis, post-traumatic arthritis, spastic flexion contracture, degenerative scaphoid nonunion, or those who have experienced failure of wrist arthroplasty. The surgical approach involves making an incision along the midline of the posterior aspect of the wrist, extending from the distal forearm to the proximal metacarpal region. During the procedure, the surgeon exposes the radiocarpal joint and the distal radioulnar joint (DRUJ) by releasing the retinaculum, which is a fibrous band that holds the tendons in place. Care is taken to protect the radial and ulnar nerves using vessel loops, and the tendons are retracted to provide a clear view of the joint. The articular cartilage is then removed using specialized instruments such as a rongeur or bur. In the case of CPT® Code 25820, the focus is on a limited fusion of the radiocarpal or intercarpal joints, which are stabilized using internal fixation devices like pins or plates and screws. This procedure does not involve the use of a bone graft, distinguishing it from other related procedures. After the fusion, the surgical site is closed in layers, and the wrist is immobilized in a cast to promote healing and ensure proper alignment during recovery.