Carpal tunnel syndrome, unspecified upper limb
Carpal Boss ICD-10. M25.731 - Osteophyte, right wrist; M25.732 - Osteophyte, left wrist; M25.739 - Osteophyte, unspecified wrist; M25.741 - Osteophyte, right hand; M25.742 - Osteophyte, left hand; M25.749 - Osteophyte, unspecified hand; Carpal Boss ICD-9. 726.91(exostosis of unspecified site)
· Carpal tunnel syndrome, unspecified upper limb. G56.00 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM G56.00 became effective on October 1, 2021.
0PBM0ZZ Excision of Right Carpal, Open Approach. 0PBM3 Percutaneous. 0PBM3Z No Device. 0PBM3ZX Excision of Right Carpal, Percutaneous Approach, Diagnostic. 0PBM3ZZ Excision of Right Carpal, Percutaneous Approach. 0PBM4 Percutaneous Endoscopic. 0PBM4Z No Device.
· Therefore, you should report 26230 (Partial excision [craterization, saucerization, or diaphysectomy] bone [e.g., osteomyelitis]; metacarpal) when the surgeon documents carpal bossing. For the diagnosis code, the American Society for Surgery of the Hand recommends 718.04 (Articular cartilage disorder; hand).
If your wrist bones formed incorrectly when you were born, then you may have or develop a carpal boss. Arthritic conditions. Conditions like osteoarthritis can damage the cartilage in your joint, leading bones to rub together and possibly form bone spurs. In the wrist, this may appear as a bossing.
While carpal tunnel syndrome is caused by the same repetitive motions irritating the median nerve and causing discomfort in your fingers, carpal boss syndrome stems from bone overgrowth in the wrist where your index or middle fingers meet the carpal bones.
A carpal boss is also known as a bossing. It is a bony overgrowth or lump on the back of the wrist at the base of the index (pointer finger) or long (middle finger) metacarpal bones where they join the carpal bones.
Some people experience carpal boss after a wrist injury or if their job requires repetitive wrist motions. It can also be caused by, or aggravated by, playing racquet sports, such as tennis, racquetball or pickleball, or by playing golf.
The main symptom of a carpal boss is a firm lump on the back of your wrist. You can have it in either one or both wrists. Most people don't have any other symptoms. However, sometimes the bump becomes tender to the touch or painful when you move your wrist.
You may have a condition known as carpometacarpal boss, or carpal boss for short. It is an overgrowth of the bone which isn't usually worrisome unless your wrist becomes swollen and causes you pain.
Causes and Risk Factors Researchers have yet to pin down the exact cause of carpal boss, but they believe it's related to certain conditions, including osteoarthritis, wrist overuse, joint trauma, and congenital issues. The formation typically strikes at age 40 and above for both men and women.
Carpal boss is often seen on imaging both in symptomatic and asymptomatic patients. Patients typically present with a local swelling and /or pain. The etiology is still unclear. Radiography and especially CT can analyze the bony morphology, but fail to correlate with the experienced pain.
It occurs equally in men and women. Usually the boss occurs on one wrist, but occasionally it can be present on both. Patients notice a firm, immovable bump on the back of the wrist or hand. It can be painless or tender and achy.
It is a bony overgrowth or lump on the back of the wrist at the base of the index (pointer finger) or long (middle finger) metacarpal bones where they join the carpal bones.
Steroid injection into the boss. Surgery. Surgery may be recommended if the carpal boss has been painful for an extended period of time, if non-surgical treatment has failed, or if there is painful snapping of the tendons. Surgery involves removing the boss.
The boss is frequently mistaken for a ganglion cyst because of their similar appearance and location (Figure 1). Some patients can have a ganglion that arises from the boss itself. An x-ray of a carpal boss is shown in figure 2.