How To Use CPT Code 25400

CPT 25400 describes the repair of a nonunion or malunion deformity in either the radius or ulna bone of the lower arm. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 25400?

CPT 25400 is used to describe the repair of a nonunion or malunion deformity in either the radius or ulna bone of the lower arm. This code is used when the provider cuts through the undeveloped or improperly grown bone and fixes it by pulling together the ends. The procedure does not involve the use of a graft.

2. Official Description

The official description of CPT code 25400 is: ‘Repair of nonunion or malunion, radius OR ulna; without graft (eg, compression technique)’

3. Procedure

1. The provider makes an incision over the radial or ulnar shaft and exposes the area of nonunion or malunion.
2. Using a cutting instrument like an electrical saw, the provider excises the irregular bony area.
3. The provider pulls both bone ends together and fixes them in place, such as with screws and plates.
4. At the end of the surgery, the provider irrigates and sutures the operative site and places a splint for the immobilization of the arm.

4. Qualifying circumstances

Patients eligible to receive CPT 25400 services are those with a nonunion or malunion deformity in either the radius or ulna bone of the lower arm. Nonunion refers to the lack of bone union after a fracture, while malunion refers to incomplete or faulty union of a bone after a fracture. The procedure does not involve the use of a graft.

5. When to use CPT code 25400

CPT code 25400 should be used when the provider performs a repair of a nonunion or malunion deformity in either the radius or ulna bone of the lower arm without the use of a graft. If a graft is used, a different CPT code should be reported.

6. Documentation requirements

To support a claim for CPT 25400, the provider must document the following information:

• Patient’s diagnosis of nonunion or malunion deformity in either the radius or ulna bone
• Description of the procedure performed, including the incision, excision of the irregular bony area, and fixation of the bone ends
• Date of the surgery
• Start and end time of the procedure
• Details of any additional procedures performed during the surgery
• Signature of the provider performing the surgery

7. Billing guidelines

When billing for CPT 25400, ensure that the procedure performed is a repair of a nonunion or malunion deformity in either the radius or ulna bone of the lower arm without the use of a graft. Do not report CPT 25400 if a graft is used, as a different CPT code should be reported in that case.

8. Historical information

CPT 25400 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A provider performs a repair of a nonunion deformity in the radius bone of the lower arm without the use of a graft.
2. A patient presents with a malunion deformity in the ulna bone of the lower arm, and the provider performs a repair without the use of a graft.
3. A provider treats a nonunion deformity in the radius bone of the lower arm without the use of a graft.
4. A patient has a malunion deformity in the ulna bone of the lower arm, and the provider performs a repair without the use of a graft.
5. A provider performs a repair of a nonunion deformity in the radius bone of the lower arm without the use of a graft.
6. A patient presents with a malunion deformity in the ulna bone of the lower arm, and the provider performs a repair without the use of a graft.
7. A provider treats a nonunion deformity in the radius bone of the lower arm without the use of a graft.
8. A patient has a malunion deformity in the ulna bone of the lower arm, and the provider performs a repair without the use of a graft.
9. A provider performs a repair of a nonunion deformity in the radius bone of the lower arm without the use of a graft.
10. A patient presents with a malunion deformity in the ulna bone of the lower arm, and the provider performs a repair without the use of a graft.