How To Use CPT Code 25525

CPT 25525 describes the open treatment of a radial shaft fracture, including internal fixation if necessary, and the closed treatment of a distal radioulnar joint dislocation (Galeazzi fracture/dislocation), including percutaneous skeletal fixation if performed. 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 25525?

CPT 25525 is used to describe the open treatment of a radial shaft fracture, which involves repairing the fracture and stabilizing it with internal fixation if necessary. Additionally, this code covers the closed treatment of a distal radioulnar joint dislocation, which involves realigning the bones without making an incision and may include percutaneous skeletal fixation if performed.

2. Official Description

The official description of CPT code 25525 is: ‘Open treatment of radial shaft fracture, includes internal fixation, when performed, and closed treatment of distal radioulnar joint dislocation (Galeazzi fracture/dislocation), includes percutaneous skeletal fixation, when performed.’

3. Procedure

1. The provider begins by making an incision over the fracture site to access the radial shaft.
2. If necessary, the provider applies internal fixation, such as plates, screws, nails, or wires, to stabilize the fracture.
3. The provider then manually realigns the bones at the distal radioulnar joint without making an incision.
4. If needed, the provider may insert pins or wires through the skin into the joint to further stabilize the bones, using fluoroscopic imaging for guidance.
5. After ensuring proper alignment and stabilization, the provider irrigates the area, checks for bleeding, removes any instruments, and closes the incision.
6. A splint or cast may be applied to support the healing process.

4. Qualifying circumstances

CPT 25525 is performed when a patient has a radial shaft fracture and a dislocation of the distal radioulnar joint (Galeazzi fracture/dislocation). The procedure is typically performed by a qualified healthcare professional, such as an orthopedic surgeon, and may involve the use of internal fixation and percutaneous skeletal fixation.

5. When to use CPT code 25525

CPT code 25525 should be used when a provider performs the open treatment of a radial shaft fracture, including internal fixation if necessary, and the closed treatment of a distal radioulnar joint dislocation, including percutaneous skeletal fixation if performed. It is important to accurately document the specific procedures performed to support the use of this code.

6. Documentation requirements

To support a claim for CPT 25525, the provider must document the following information:

• Diagnosis of radial shaft fracture and distal radioulnar joint dislocation
• Description of the open treatment procedure, including any internal fixation performed
• Description of the closed treatment procedure, including any percutaneous skeletal fixation performed
• Date of the procedure
• Start and end time of the procedure
• Any additional procedures or interventions performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 25525, ensure that the procedure meets the criteria for open treatment of a radial shaft fracture and closed treatment of a distal radioulnar joint dislocation. Use the appropriate modifiers if necessary, such as modifier 22 for increased procedural complexity or modifier 59 for distinct procedural services. It is important to follow the specific billing guidelines of the payer to ensure accurate reimbursement.

8. Historical information

CPT 25525 was added to the Current Procedural Terminology system on January 1, 1993. There have been several code changes since its addition, including updates to the description and inclusion of additional procedures.

9. Examples

1. An orthopedic surgeon performs an open treatment of a radial shaft fracture with internal fixation and a closed treatment of a distal radioulnar joint dislocation for a patient involved in a car accident.
2. A patient presents with a Galeazzi fracture/dislocation, and the provider performs an open treatment of the radial shaft fracture with internal fixation and a closed treatment of the distal radioulnar joint dislocation, including percutaneous skeletal fixation.
3. A cyclist sustains a radial shaft fracture and a distal radioulnar joint dislocation, and the provider performs an open treatment with internal fixation and a closed treatment of the dislocation without percutaneous skeletal fixation.
4. An elderly patient falls and fractures their radial shaft, requiring open treatment with internal fixation and closed treatment of the distal radioulnar joint dislocation.
5. A child presents with a Galeazzi fracture/dislocation, and the provider performs an open treatment of the radial shaft fracture with internal fixation and a closed treatment of the distal radioulnar joint dislocation, including percutaneous skeletal fixation.
6. A patient sustains a radial shaft fracture and a distal radioulnar joint dislocation due to a sports injury, and the provider performs an open treatment with internal fixation and a closed treatment of the dislocation without percutaneous skeletal fixation.
7. An orthopedic surgeon performs an open treatment of a radial shaft fracture with internal fixation and a closed treatment of a distal radioulnar joint dislocation for a patient involved in a fall.
8. A patient presents with a Galeazzi fracture/dislocation, and the provider performs an open treatment of the radial shaft fracture with internal fixation and a closed treatment of the distal radioulnar joint dislocation, including percutaneous skeletal fixation.