1. Procedure Type: This scenario describes a secondary repair of two extensor tendons in the wrist with a free graft. According to CPT® coding guidelines, the secondary repair with a free graft suggests a more complex repair than primary closure.
2. CPT® Code Selection:
Code 25270 is used for a primary repair of an extensor tendon in the forearm or wrist. Since this is a secondary repair, 25270 does not apply, ruling out options A and C.
Code 25272 represents the repair of a single extensor tendon in the forearm or wrist, which includes both primary and secondary repairs. However, it does not involve free grafts, ruling out option D.
Code 25274 specifically addresses the secondary repair of an extensor tendon with free graft in the forearm or wrist, which is the correct scenario described in the question.
3. Applying the Code for Multiple Tendons:
Since the procedure involves two tendons, 25274 should be reported twice (25274 x 2) to account for the secondary repair on each tendon individually.
4. Reference from AAPC CPC Guidelines:
In AAPC CPC and CPT® coding principles, tendon repair codes require careful distinction between primary repairs and secondary repairs with grafts. The guidelines specify that multiple tendons should be coded with individual codes when performed on separate anatomical structures, hence the use of 25274 twice for both tendons.
Therefore, the verified and precise answer based on CPT® guidelines and AAPC coding standards is B. 25274 x 2.
