How To Use CPT Code 25605

CPT 25605 refers to the closed treatment of distal radial fractures with manipulation. This article will cover the description, procedure, qualifying circumstances, when to use the code, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 25605 procedures.

1. What is CPT 25605?

CPT 25605 is a medical billing code used to describe the closed treatment of distal radial fractures, such as Colles or Smith type fractures, or epiphyseal separation, with manipulation. This code is used when a healthcare provider treats a wrist fracture without making an incision and manipulates the fracture to realign the bony structures.

2. 25605 CPT code description

The official description of CPT code 25605 is: “Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; with manipulation.”

3. Procedure

The 25605 procedure involves the following steps:

1. The patient is appropriately prepped and anesthetized.
2. The provider determines the presence of the distal radial fracture with radiographic imaging.
3. The provider uses their hands to manipulate the bony structures into their correct positions.
4. Another radiographic image is obtained to confirm adequate reduction of the fracture.
5. A splint or cast material is applied to prevent movement of the fracture until healing takes place.

4. Qualifying circumstances

Patients eligible to receive CPT code 25605 services are those who have sustained a distal radial fracture, such as a Colles or Smith type fracture, or an epiphyseal separation. The fracture must be treated in a closed manner, meaning no incision is made, and the provider must manipulate the fracture to realign the bony structures. Additionally, the code includes the closed treatment of a fracture of the ulnar styloid when performed.

5. When to use CPT code 25605

It is appropriate to bill the 25605 CPT code when a healthcare provider performs a closed treatment of a distal radial fracture or epiphyseal separation with manipulation. This code should be used when the provider does not make an incision and manipulates the fracture to realign the bony structures. The code also applies when the closed treatment of a fracture of the ulnar styloid is performed.

6. Documentation requirements

To support a claim for CPT 25605, the following information should be documented:

• Patient’s medical history and physical examination findings
• Diagnosis of distal radial fracture or epiphyseal separation
• Radiographic imaging confirming the presence of the fracture
• Details of the closed treatment procedure, including manipulation and realignment of the bony structures
• Radiographic imaging confirming adequate reduction of the fracture
• Application of a splint or cast material to immobilize the fracture
• Follow-up care instructions and plan for monitoring the healing process

7. Billing guidelines

When billing for CPT code 25605, keep in mind the following guidelines and tips:

• Do not report CPT 25600 or 25605 in conjunction with CPT 25650.
• Consider using modifier 54 (Surgical care only) if the provider will not see the patient for follow-up care and is billing only for the surgical portion of the code.
• Report additional supplies of casting materials using the appropriate Q HCPCS codes.
• When applicable, use modifier 25 (Significant, separately identifiable E/M service) to report a separate evaluation and management service provided on the same day as the procedure.

8. Historical information

CPT 25605 was added to the Current Procedural Terminology system on January 1, 1990. The code was changed on January 1, 2007, with the previous descriptor being “Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation, with or without fracture of ulnar styloid; with manipulation.”

9. Similar codes to CPT 25605

Five similar codes to CPT 25605 and how they differentiate are:

• CPT 25600: Closed treatment of distal radial fracture without manipulation.
• CPT 25607: Open treatment of distal radial fracture with internal fixation.
• CPT 25608: Open treatment of distal radial fracture with internal fixation and fragment-specific fixation.
• CPT 25609: Percutaneous skeletal fixation of distal radial fracture.
• CPT 25650: Closed treatment of ulnar styloid fracture.

10. Examples

Here are 10 detailed examples of CPT code 25605 procedures:

1. A patient with a Colles fracture is treated with closed reduction and manipulation, followed by the application of a cast.
2. A patient with a Smith fracture undergoes closed reduction with manipulation and is immobilized with a splint.
3. A patient with an epiphyseal separation of the distal radius receives closed treatment with manipulation and cast application.
4. A patient with a distal radial fracture and ulnar styloid fracture undergoes closed reduction with manipulation and cast immobilization.
5. A patient with a displaced distal radial fracture is treated with closed reduction, manipulation, and splinting.
6. A patient with a distal radial fracture and associated ulnar styloid fracture receives closed treatment with manipulation and cast application.
7. A patient with a Colles fracture undergoes closed reduction with manipulation, followed by the application of a splint.
8. A patient with a Smith fracture is treated with closed reduction, manipulation, and cast immobilization.
9. A patient with an epiphyseal separation of the distal radius undergoes closed treatment with manipulation and splint application.
10. A patient with a displaced distal radial fracture and ulnar styloid fracture receives closed reduction with manipulation and cast immobilization.