How To Use CPT Code 25526

CPT code 25526 describes the open treatment of a radial shaft fracture, including internal fixation, and the open treatment of a distal radioulnar joint dislocation (Galeazzi fracture/dislocation), including repair of the triangular fibrocartilage complex. 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 25526?

CPT 25526 can be used to describe the open treatment of a radial shaft fracture, which involves repairing the fracture and the dislocation of the distal radioulnar joint. The procedure includes internal fixation, which may involve the use of plates, screws, nails, or wires to stabilize the fracture and the joint. Additionally, the triangular fibrocartilage complex (TFCC) is repaired during this procedure.

2. Official Description

The official description of CPT code 25526 is: ‘Open treatment of radial shaft fracture, includes internal fixation, when performed, and open treatment of distal radioulnar joint dislocation (Galeazzi fracture/dislocation), includes internal fixation, when performed, includes repair of triangular fibrocartilage complex.’

3. Procedure

1. The provider begins by making an incision over the area of the fracture and the dislocation.
2. The fracture is reduced, and if necessary, hardware such as plates and screws or wires are applied to maintain the reduction.
3. The provider then repairs the triangular fibrocartilage complex through the same incision.
4. Next, the provider incises the area over the dislocation and realigns the bones at the radioulnar joint.
5. If needed, pins or wires may be inserted to stabilize the bones.
6. The provider irrigates the area, checks for bleeding, removes any instruments, and closes the incision.
7. A splint or cast is applied to support the healing process.

4. Qualifying circumstances

CPT 25526 is performed on patients who have a radial shaft fracture and a dislocation of the distal radioulnar joint. The procedure is typically performed in an open surgical setting and requires internal fixation to stabilize the fracture and the joint. The repair of the triangular fibrocartilage complex is also included in this code.

5. When to use CPT code 25526

CPT code 25526 should be used when a provider performs an open treatment of a radial shaft fracture, including internal fixation, and an open treatment of a distal radioulnar joint dislocation, including internal fixation and repair of the triangular fibrocartilage complex. This code accurately describes the procedure performed and should be reported for each instance of this treatment.

6. Documentation requirements

To support a claim for CPT 25526, the provider must document the following information:

• Diagnosis of the radial shaft fracture and the distal radioulnar joint dislocation
• Details of the procedure performed, including the incision, reduction of the fracture, application of hardware, repair of the triangular fibrocartilage complex, realignment of the bones at the radioulnar joint, and closure of the incision
• Any additional procedures or services provided during the same encounter
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 25526, ensure that the procedure meets the criteria outlined in the code description. The provider should perform an open treatment of a radial shaft fracture, including internal fixation, and an open treatment of a distal radioulnar joint dislocation, including internal fixation and repair of the triangular fibrocartilage complex. It is important to follow any additional guidelines provided by the payer or coding guidelines specific to your region.

8. Historical information

CPT 25526 was added to the Current Procedural Terminology system on January 1, 1993. Since its addition, there have been a few changes to the code description, including updates to clarify the inclusion of internal fixation and repair of the triangular fibrocartilage complex.

9. Examples

1. A patient presents with a radial shaft fracture and a dislocation of the distal radioulnar joint. The provider performs an open treatment of the fracture, including internal fixation, and repairs the triangular fibrocartilage complex. The procedure is documented and coded as CPT 25526.
2. Another patient has a radial shaft fracture and a dislocation of the distal radioulnar joint. The provider performs an open treatment of the fracture, including internal fixation, and repairs the triangular fibrocartilage complex. The procedure is documented and coded as CPT 25526.
3. A third patient presents with a radial shaft fracture and a dislocation of the distal radioulnar joint. The provider performs an open treatment of the fracture, including internal fixation, and repairs the triangular fibrocartilage complex. The procedure is documented and coded as CPT 25526.
4. Yet another patient has a radial shaft fracture and a dislocation of the distal radioulnar joint. The provider performs an open treatment of the fracture, including internal fixation, and repairs the triangular fibrocartilage complex. The procedure is documented and coded as CPT 25526.