How To Use CPT Code 25500

CPT 25500 describes the closed treatment of a fracture in the shaft of the radius, one of the bones in the forearm, without manipulation. 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 25500?

CPT 25500 is used to describe the closed treatment of a fracture in the shaft of the radius, which is one of the bones in the forearm. This procedure does not involve making an incision or manipulating the fracture. The provider applies a splint to prevent movement of the fracture until it heals.

2. Official Description

The official description of CPT code 25500 is: ‘Closed treatment of radial shaft fracture; without manipulation.’

3. Procedure

1. The provider uses radiographic imaging to determine the presence of a fracture in the shaft of the radius.
2. If a fracture is confirmed, the provider assesses the alignment of the fracture to ensure it is satisfactory.
3. The provider applies a splint to immobilize the fracture and prevent movement during the healing process.

4. Qualifying circumstances

CPT 25500 is used for patients who have a fracture in the shaft of the radius that can be treated without the need for surgical incision or manipulation. The provider determines the need for closed treatment based on radiographic imaging and the alignment of the fracture.

5. When to use CPT code 25500

CPT code 25500 should be used when the provider performs closed treatment of a fracture in the shaft of the radius without manipulation. This code is appropriate when no surgical incision is made and the fracture is immobilized with a splint.

6. Documentation requirements

To support a claim for CPT 25500, the provider must document the following information:

• Radiographic imaging confirming the presence of a fracture in the shaft of the radius
• Assessment of the alignment of the fracture
• Description of the splint applied to immobilize the fracture

7. Billing guidelines

When billing for CPT 25500, ensure that the treatment is performed without manipulation and without making a surgical incision. It is important to accurately document the procedure and provide the necessary supporting documentation. Modifier 54, Surgical care only, may be used if the provider will not see the patient for follow-up care. Additionally, consider reporting separate evaluation and management (E/M) services if applicable.

8. Historical information

CPT 25500 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 patient presents with a fracture in the shaft of their radius. The provider confirms the fracture with radiographic imaging and determines that closed treatment without manipulation is appropriate. The provider applies a splint to immobilize the fracture.
2. After a fall, a patient is diagnosed with a fracture in the shaft of their radius. The provider assesses the alignment of the fracture and determines that closed treatment without manipulation is necessary. A splint is applied to prevent movement of the fracture.
3. A patient sustains a fracture in the shaft of their radius during a sports activity. The provider uses radiographic imaging to confirm the fracture and decides that closed treatment without manipulation is the most appropriate course of action. The fracture is immobilized with a splint.
4. Following a car accident, a patient is found to have a fracture in the shaft of their radius. The provider determines that closed treatment without manipulation is suitable and applies a splint to stabilize the fracture.
5. A patient presents with pain and swelling in their forearm. Radiographic imaging reveals a fracture in the shaft of their radius. The provider opts for closed treatment without manipulation and applies a splint to support the fracture during the healing process.