How To Use CPT Code 25492

CPT 25492 describes the prophylactic treatment of a defect in the radius and ulna bones using fixation implants such as nails, plates, or screws, with or without the use of methylmethacrylate. 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 25492?

CPT 25492 is used to describe the prophylactic treatment of a defect in both the radius and ulna bones. The procedure involves the use of fixation implants, such as nails, plates, or screws, to stabilize the bones and prevent future issues. The provider may also use methylmethacrylate, a type of bone cement, to provide additional stability.

2. Official Description

The official description of CPT code 25492 is: ‘Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; radius AND ulna.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider makes an incision in the skin above the defect in the radius bone and extends it towards the ulnar side.
3. The provider dissects down through the subcutaneous tissue to expose the forearm bones, the radius, and ulna.
4. The provider uses fixation implants, such as nails, pins, plates, or wires, to fix the defect in the bones and stabilize them.
5. If necessary, the provider may use methylmethacrylate, a type of bone cement, to fill the defect and provide additional stability.
6. The provider obtains hemostasis at the surgical site and closes the wound by suturing the soft tissue in layers.

4. Qualifying circumstances

CPT 25492 is performed on patients who have a defect in both the radius and ulna bones that requires prophylactic treatment. The procedure is typically done to prevent future issues and stabilize the bones. The use of fixation implants, such as nails, plates, or screws, is necessary, and the provider may or may not use methylmethacrylate, a type of bone cement, depending on the specific case.

5. When to use CPT code 25492

CPT code 25492 should be used when the provider performs prophylactic treatment on both the radius and ulna bones using fixation implants. This code is appropriate when the procedure is done to prevent future issues and stabilize the bones. If the treatment is only performed on the radius bone, use CPT code 25490. If it is only performed on the ulna bone, use CPT code 25491.

6. Documentation requirements

To support a claim for CPT code 25492, the provider must document the following information:

• Patient’s diagnosis and the need for prophylactic treatment
• Specific fixation implants used, such as nails, plates, or screws
• Use of methylmethacrylate, if applicable
• Date of the procedure
• Details of the procedure, including the incision, dissection, implantation, and closure
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT code 25492, ensure that the procedure involves the prophylactic treatment of both the radius and ulna bones using fixation implants. If the treatment is only performed on one bone, use the appropriate CPT code (25490 for the radius bone, 25491 for the ulna bone). There are no specific guidelines regarding reporting CPT code 25492 with other codes.

8. Historical information

CPT code 25492 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 surgeon performing prophylactic treatment on a patient with a defect in both the radius and ulna bones using plates and screws.
2. An orthopedic specialist using nails and methylmethacrylate to stabilize the radius and ulna bones in a patient with a defect.
3. A trauma surgeon performing prophylactic treatment on a patient’s radius and ulna bones using wires and plates.
4. An orthopedic surgeon using screws and methylmethacrylate to fix a defect in both the radius and ulna bones in a patient.
5. A pediatric orthopedic specialist performing prophylactic treatment on a child’s radius and ulna bones using pins and plates.
6. A hand surgeon using screws and methylmethacrylate to stabilize the radius and ulna bones in a patient with a defect.
7. An orthopedic specialist performing prophylactic treatment on a patient’s radius and ulna bones using nails and plates.
8. A trauma surgeon using screws and methylmethacrylate to fix a defect in both the radius and ulna bones in a patient.
9. An orthopedic surgeon performing prophylactic treatment on a patient’s radius and ulna bones using wires and plates.
10. A pediatric orthopedic specialist using pins and methylmethacrylate to stabilize the radius and ulna bones in a child with a defect.