Question

Mrs. Mason has complained of left-hand pain, numbness, and a tingling sensation. Tinel’s and Phalen’s signs have been positive on serial examinations, and an EMG has confirmed the diagnosis. Mrs. Mason presents today for the release of left carpal tunnel.

Under general anesthesia, the procedure was successfully completed and the patient was awakened and taken to the recovery room in stable condition. Upon discharge to home later this afternoon, we will review postoperative instructions and things to watch out for

What is the CPT code (s)? Modifier if appropriate?

Answer 1

Ans. Carpal tunnel syndrome is a condition of increased pressure within the wrist on a nerve called the median nerve going through a passage in the wrist called the carpal tunnel, that leads to numbness, tingling sensation, pain, or weakness in the hand and wrist.

CPT is current procedural terminology, these are the numerical codes used to identify medical services and procedures provided by qualified healthcare professionals.

CPT code for carpal tunnel release surgery is 64721.

No modifier is appropriate looking at the description provided.

An example of modifier in this scenario would be --

The modifier, 50, will be appropriate in this scenario when there would be a bilateral procedure performed at the same session, for example -- when the surgeon would have performed a carpal tunnel surgery on the right and left wrist during the same operative session. But here as such is not mentioned and only about the left-hand pain is specified. So, no modifier is appropriate.